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RE: [IPp] Pump, insurance help (long)

Not sure if this was mentioned but what APPEARS to be the problem here is
within the contract between the pump company and the insurance company.  But
the TRUE problem is a clinic that thinks they can charge an outrageous
amount for such training that I got for free in my Dallas area home, over a
3-hour time frame.

>From what I understand, once a year the pump companies come to an agreement
on a contract with the insurance companies that will cover all pump
prescriptions. That contract is valid for the entire year and covers all
patients, and in most cases in not up for renegotiations. In most (if not
all pump company) contracts, the training cost is built in because the pump
companies OFFER this as part of a service to their customers, also, it
ensures that their own trained staff (Pump start up is all they do!) are
teaching the end user, VERSES a secondary trained staff (the medical staff
sill has to be "certified by the pump company in order to train others".)
Mike in your case, I know the staffers were "CERTIFIED" a while back, you
may want to ask when they were last trained on your specific pump.

So, if a clinic, like the one that Mike goes to, request additional training
and charges the customer, it's VERY unlikely the insurance company will pay
for pump training TWICE, and quite frankly I don't want them paying twice
for the same thing.. do you? It's more money out of all of our pockets in
the long run.

The only chance here is to find a new ENDO, or convince the insurance
company and pump company re-negotiate the contract, and I can almost bet,
that the pump companies do NOT charge $1,600+ for their 3 hour training

I have heard from a good source, in the state of Texas, that MANY MANY
complaints have been filed against this particular Clinic for this very
reason. My personal issues with this clinic are NOT a secret; I feel they
are criminal in many of their acts, including trying to double dip with the
insurance companies or take severe advantage of those that can afford the
money (or scrape up because they don't know any better)

Sorry to be so opinionated on this one, I gave Mike my contact numbers for
State Authorities on this issue, and he knows I love him! :)  : )
Connie Miller
Dallas Area,
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