Wound Center Charges Explained

On Monday, I wrote (complained!) about the bill I had for the wound center charges. I had a phone call this AM from someone at Ohio Valley General Hospital – my letter was kicked over to her because I used the word “fraud.” She went thru and explained everything to me. My insurance lumped how they billed it under “operating room services” but that was not the code they used. Had I spoken to her on Monday instead the person that I got bumped over to, I would not have been as upset as I was. I should have asked to talk to a supervisor or someone else when I called Monday, but unfortunately, I didn’t.

The phone call had an unexpected turn. During our billing discussion, I brought up what CCS did with my Dexcom sensors. I asked her if she knew what a CGMS was – she not only knew, she has the MM one. She did not know about Dexcom or their new one coming out. When I told her about the Dexcom group on TuDiabetes, she did not know about TuDiabetes either so will check that out.

We were both able to help each other out!


My Fake Pinboard

Today’s prompt for Day 16 of the Wego Health Activist Writer’s Challenge is, “Pinboard. Create a pinterest board for your health focus. Pin 3 things. What did you pin? Share the images in a post and explain why you chose them.”

I setup an account at Pinterest for this post but I haven’t done anything with it yet nor have even “looked” to figure out what to do there. I had a good laugh today when a friend said that I seemed “distracted and scattered” lately! I have been being pulled in too many different directions lately so decided to take the easy way out with this post and not bother with Pinterest. I figured I would pick out 3 pictures that I already have and go from there.

I picked the Dexcom saying low for my first picture. For those people that don’t have a Dexcom, your blood sugar has to be below 40 for it to say low. And yes, I treated the low before taking a picture! Being low is no fun. I don’t feel most of my lows, so the Dexcom helps catch them before I get too low. Even with the Dexcom though, if you are dropping fast, you can still end up “low.”

Dexcom Low

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Don’t Even “Think” About Having Pizza!

Police CarLast week was just a tad stressful. I wrote about my stalker making another appearance. I called the police on Wednesday to let them know I had another problem with him. The police officer that I was working with wanted to come by Friday morning. I also had another problem pop up on Thursday that I wasn’t expecting. I want to wait until that gets settled before writing about it online. Needless to say, I didn’t get much sleep Thursday night and wanted to get up early Friday morning so I could get my shower before he got there.

PizzaBy the time dinner rolled around on Friday, I was exhausted. I thought that this would be a good night to order some pizza. Then I thought because I was so tired, I really didn’t want to have to baby-sit blood sugar all night because of eating pizza. This little debate went on for probably about 45 minutes in my head until I finally decided against it. I really just wanted to go to sleep.

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Crash: Bad Timing

People For Quality Care BadgeI don’t think that there is ever a good time to have your blood sugar crash, but some days are just far worse than others. Last week, People For Quality Care asked me if I would participate in a town hall teleconference that they were having for the Philadelphia area yesterday afternoon. Philadelphia is included in the next areas to be added to the Medicare competitive bidding program. I would discuss the program’s impact on diabetics.

This was a big step outside of my comfort zone. I do much better in one-on-one situations or very small groups. I freeze in front of large groups. I worked for a company that was buying the company from the previous owner when he died. His estate had various terms that had to be agreed to. At one point, they had questions on the financial statements. My boss didn’t want to go and I had to sit with our attorney on one side of the table and was grilled by the estate’s attorney and accountant. I had no problem doing that but another time, I had to speak in front of about 100 employees. I knew most of them but when I had to stand up in front of everyone at once, I shook. I figured being on the phone would be easier than being in person. I was honored to be asked to this and terrified at the same time.

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What Now? Crazy BS or DP?

I swear as soon as you get one problem solved, something else rears its ugly head! Since I got my new box of Levemir last week, my blood sugar has been fairly good other than when I decided to treat myself with some homemade peanut butter cups – I know, bad but they were good!

Monday was a very good blood sugar day and my blood sugar was in good shape when I went to bed Monday night. A friend of mine sent me some expired Dexcom sensors that she had so I am using my Dexcom again – even though the sensors are expired, they are doing really great. About 4:00 AM Tuesday morning, I heard the Dexcom beep. I have my high alarm set at 120 and it had me a little above that. When I went to bed, it was a little below my meter so I thought that I was probably higher than 120. I grabbed my meter and tested. I saw this on my meter:

AccuChek Aviva blood sugar 111

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Medicare and CGMS Coverage

Dexcom Double Down Arrow LowSomeone recently landed on my blog using the search term “how to get a Dexcom approved by Medicare.” If you want to believe the standard line that Medicare doesn’t cover a CGMS, then I suggest you not waste your time reading this article. If you aren’t willing to accept the standard answer, then keep reading. I am on Medicare and have a Medicare Advantage Plan. Guess what, they paid for both a Freestyle Navigator and a Dexcom.

If you try to get a CGMS with Medicare, you are going to be told that it isn’t covered. And yes, I heard the “your insurance doesn’t cover that” plenty of times. Abbott told me that when I tried to get the Navigator and Dexcom told me that when I tried to get the Dexcom. Dexcom also told me that even after I had been using the Dexcom for a year and my insurance had been paying for it. I also heard it from supply companies. I have seen that statement made repeatedly on diabetes message boards but if I ask if they tried to file an appeal with their insurance company, they just repeat again that it isn’t covered. Sometimes even with traditional insurance, you have to fight for what you need. Medicare is no different.

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