RE: [IP] Insurance limiting # of test strips
> Have your DR submit a medical necessity form.
>
> -----Original Message-----
> From: email @ redacted
> [mailto:email @ redacted] On Behalf Of Shirley Clegg
> Sent: Tuesday, February 28, 2006 5:19 PM To: email @ redacted
> Subject: [IP] Insurance limiting # of test strips
>
> Help! Has anyone had problems (and solutions) to insurance limiting
> test strips? I have Tricare Prime and my Endo has prescribed testing 10
> times a day which is a lot, but I had spinal surgery which failed big
> time and I've been fighting pain, steroid injections, etc. for the past
> 9 months which is playing havoc with my BG #'s. Today with new scrip,
> pharmacist got denial of 10 strips per day. Any suggestions and thanks
> so much for all the good thoughts! .
Call the ins co and ask for pharmacy services of the pharmacy
coordinator. Insist that the show you where in your "contract of
insurance" is says that the number of strips is limited to a particular
number, specifically .... why are they disregarding the physicians
order with respect to a prescription? Are they practicing medicine? Of
course they will deny everything. Don't listen to any crap about "it's
our policy to .... blah blah". Escalate the problem to a supervisor.
Get your doctor to write a letter if necssary stating that you are to
test:
in the morning when you get up.
before each meal
2 hours post prandial
before operating a motor vehicle or heavy equipment and
every hour while doing so.
when you feel low and every 20 minutes until the low is corrected
when you feel high and every hour until it is corrected
before bed
hmm.... that is at least 10x per day ;-)
They will have a tough time rebutting that. I don't suppose they would
like you to not test before driving, have an accident, then blame them.
Intimidation is the answer ;-) ...besides, they are under contract to
provide the test strips that the doctor orders.
Michael
.
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