7 Steps to Uninterrupted Diabetes Supplies

Along with medication, an insulin pump or continuous glucose monitor supplies are essential to managing diabetes.  The following 7 steps include essential information that will help reduce the possibility that your supplies are interrupted!  If you are new to Rocky Mountain Pharmacy, visit our New Patients  web page, to review the initial processes that help get things started out smoothly and the approximate time frames to anticipate for orders to be filled.

Step 1:  Ensure that you have regular visits with your healthcare provider.

You are responsible to have regularly scheduled healthcare provider visits to get ongoing pump and CGM supplies. Missed or infrequent visits can result in our staff not having required documentation for you to get your supplies authorized based on your insurance requirements.

Notes from your visits with your healthcare provider may take 2 business days before they are available to send. Please note that research, lab only, and education visits do not count for these requirements.

Insurance Requirements

Step 2:  Take and upload your pump, CGM, and/or meter at every healthcare visit.

Healthcare providers are often asked for blood sugar reports from your insurance provider to re-certify your eligibility to receive additional testing, pump, and/or CGM supplies.  Healthcare providers can’t send what they don’t have.

Step 3:  Don’t wait until you are out of supplies to place your orders.

Remember, you are responsible for calling your supplier to order pump and/or CGM supplies. Know your insurance plan requirements. Some insurance plans require insurance approval for every order and others only require it once a year. Some insurance companies allow you to set-up an automatic shipment or reminder service which can make this easier.  Your healthcare provider will send documents and signed medical necessity forms to the distributors of the products when they request them from us, so make sure to place the order in plenty of time.

TIP: How Soon Can I Reorder?

The prescription pick-up date is the “date of service” for those items.  This date starts the time from which you can order the items again, typically 30 days or 90 days from that date, depending on your insurer.

Put a reminder on your calendar or smart device to remind you a week earlier to call and place an order.  You can also download and use the RXLocal app to manage your reminders.

Step 4:  You can get replacements for supplies that fail.

If you have a failed pump infusion set or sensor, it is imperative that you call the manufacturer to troubleshoot and obtain replacements for your failed item. Ideally, you should call when the failure happens and not wait until later. This will reduce the chance of running out before you can order more. It’s important to note that your insurance will NOT cover failures of any kind.  The manufacturer will provide replacements and send them directly to you.

TIP:  Store Helpline Numbers

Store the helpline numbers for your device(s) on your smartphone making it easy to call when you have an issue.  Most helpline numbers are listed on the packaging or insert that comes with each devise.  It is very wise to store these numbers.

Step 5:  Notify us, your healthcare provider and your suppliers of any insurance plan changes.

Different insurance plans often change the pharmacy from which you can get your supplies.  By letting us know of any changes, they can tell you if you can still get your pump/CGM supplies from us.

If we are “out of network” for your new or updated insurance plan, not telling us about the change can result in the supplies being a much higher price or not covered at all.

Also, if you know your insurance is changing at the beginning of the year, please let your healthcare provider, device coordinators, and us know as soon as possible so that we can start the authorization process.

Step 6:  Respond to phone calls or messages.

Make sure you check your voicemail messages and respond quickly. Many insurance companies (especially Medicare and Medicaid) require your verbal confirmation to fill a prescription.

Step 7:   Respond to phone calls or messages.

If there are issues processing your prescription, we will call!  Also, make sure to respond quickly to calls or messages from your healthcare provider, or the assigned care coordinator that handles the paperwork and authorization for your supplies.   They may need to reach out to you if they are missing anything needed to get your supplies reauthorized.

Care coordinators may need information such as blood sugar logs, CGM/pump downloads, or even the dated of a scheduled provider visit.  Most health care providers will make two phone calls and leave messages.  If there is no response, they will typically not continue to pursue the request until you contact them.