The ridiculousness of coordination between Dexcom and my insurance company

This year has been a joke. I love my new insurance, but getting approval for my transmitters is like pulling teeth. The funny part is that I’m pretty sure incompetence and miscommunication are the main problems! I don’t think there’s any sort of funny business going on where my insurance company is trying to avoid paying for the transmitters. The sensors have long since been approved!!! Of course, I don’t REALLY need those because I have a small stash.

I called Dexcom a little over a month ago to place the order. They told me that they’d submit the request for authorization to Carecentrix. I call a week later, and the request was never submitted. The guy on the phone said it should go out later that day but that they’d authorize overnight shipping because it had taken so long.

I call a week later, and it looks like only the request for authorization for the sensors went out, and those were approved. The Dexcom rep says they’ll send the request for authorization for the transmitters.

I call a week later, and I’m told that I requested the transmitters too early… at this point I start to get annoyed. If I requested too early, couldn’t they have just told me that when I first called!!! I request to speak to a supervisor because I’m sick of this run-around business. He says they have to wait until April 10th to send out the transmitters, but he’d put in a request for authorization a few days before.

Strangely, I get a letter in the mail from my insurance company saying that they were authorizing a receiver which I’ve never requested but wouldn’t mind getting.

I get an email from a Dexcom rep a little under a week ago saying that he’d put the request through. I get an email from him on April 9th saying that they haven’t received authorization yet and that it may help if I call Carecentrix myself. I call Carecentrix, and they say they never received the request for authorization for the transmitters, and they also say that they have nothing on file for the receiver. I request that we conference in a Dexcom representative to get to the bottom of this nonsense. Dexcom states that they sent out the request for authorization, but they say they’ll send it again. Dexcom also says that they never sent anything to my insurance company about the receiver. I suppose my insurance company just sent that letter randomly?? haha

Carecentrix is just now sending the request for authorization to my insurance company. Gah! So many levels of authorizations!

It’s a wonder anyone can have a life while trying to coordinate all of this crap.

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I have to go through carecentrix also. I’m not sure if it’s this way for everyone but I have my own designated Dexcom sales rep that I contact directly when I need to order something, she has been awesome… haven’t had a single issue… it sounds like the rep you’re dealing with may be the weak link?

I never personally interact with my insurance or carecentrix at all. Just with my Dexcom rep, whatever she does behind the scenes to coordinate, it works…

That’s pretty funny. MY DME just waited till the right time, saw that I had no insurance limitations ( I had already reached my OOP) and ordered up transmitters, six month of sensors, and a receiver ( that I’ll never use because I use xDrip+ on my watch). All this $7500 worth of supplies and I never even asked!

Just waiting for this year because I reached my OOP already

That’s how it has worked in the past for me.

My last insurance company used Carecentrix as well, but everything was much smoother because I think the insurance company allowed Carecentrix to authorize my supplies rather than getting an additional authorization from the insurance company. Dexcom hasn’t made this the easiest process though either. I’m not sure why I wasn’t setup with a Dexcom guru (sales rep) for my insurance company originally (or if there even is one). I’ll look into that because that’s what I’ve had with my last two insurance plans.

My insurance company is pretty small. They contract with Cigna to use their network. It’s kind of like a union plan. The setup for my prescription drugs (e.g. Afrezza), my office copays, and my premiums is really sweet, so I’m willing to try to make this work. I’m guessing it won’t be as difficult in the future once I’ve gotten the first authorization for the transmitters and sensors.

Sounds so simple!!! Load up on those transmitters. I’m thinking of looking into the xDrip+ because it’d be nice to maximize the transmitters better.

The timing for ordering is really specific for the transmitters, and it’s really hard to build up a stash. I wanted to have an extra one when I went to Europe, but I don’t think it’s going to ship in time (despite my attempts to order well in advance).

How long can the transmitters last on xDrip+? Also, I read somewhere that @docslotnick was going to create a guide for that. Can anyone direct me to that thread?

Can I use it with my iphone?

@Thomas How long is the shelf life?

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I’m continuing on a thread about the expected life time of a G5 transmitter. I’ve gotten about 193 days.

I kind of gave upon the guide because 1) the is so much information it’s hard to transcribe it all and 2) it’s always changing.

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@Katers87 I am having similar problems with Dexcom - almost 5 weeks after starting the process and no sensors in sight. I have called them every other day for 3 weeks before they actually got my benefits info correct. I finally had to get my primary insurer on a conference call with the Dexcom person so they could tell the Dexcom rep again what my benefits were. The sad part about this is it is a clown cop repeat of last spring, with the same problems and same players. Finally after 4 weeks they have my insurance info correct, but need a DME auth. I had called my Endo 5 weeks ago to start the auth. I can see on my side of the system it was approved 4 weeks ago. Still waiting. I swear, sometimes black market is just so much easier.

Regarding Xdrip for Apple, I hear there is an app called Spike that is similar or better than Xdrip. Since I don’t actually use the app, I couldn’t speak to the accuracy of the claim. Xdrip for the moment is Android specific. The transmitters with Xdrip can be used up to 6 months or longer depending on how fresh they were to start with. Once depleted, with a little patience and know how the batteries can be replaced for less the $5 repeatedly until the circuit board breaks.

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Thanks! I’ll take a look through this. That’s considerably longer than I expected. I could see this being especially useful if I ever need to purchase transmitters out of pocket. Which is not that unlikely if I choose to move out of the country.

Ugh! Your situation sounds worse than mine! You’re calling every other day! Crazy! I’ve basically given up. I’m hoping they’ll work out this crap on their own before my current transmitter dies. Apparently, once it dies, they’ll expedite matters and it’ll be shipped out within a day.

Thanks for the Spike recommendation! I’ll definitely consider this if I need to extend a transmitter’s life.

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@Katers87 in my area sensors are available on CL for ~$250 box of 4. Transmitters are super hard to come by, and when available are usually ~+600/ea for the G5.

Wow, that’s a lot for the transmitters. I wonder how much they cost to purchase from Dexcom without insurance. Seems like it can’t be that much more than 600.

I hope you get everything worked out soon!!

Hope y’all get it all worked out. I’m using the Libre because my insurance couldn’t even get it together to figure out who should pay for what on the Dex. :grimacing:

My last transmitter order invoice shows list price for 2 G5 transmitters as $907.xx and discounted negotiated price as $654.xx

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Byram is my medical supplier. I like Byram very much. One problem I have had there is their saying I have not paid my 20% for a shipment, and I had not received the bill. They have also notified me that it was time for me to order supplies, but it was NOT time for a few more weeks.


Finally got everything authorized!!!

It’s funny though. Carecentrix is supposed to facilitate the order between Dexcom and my insurance company, but in order to actually get this order placed, I had to speak with Dexcom, Carecentrix, and my insurance company multiple times. I facilitated the order, and Carecentrix basically got in the way. I also had to escalate it with Carecentrix every time in order for them to actually do anything.

I’m glad you like Byram @Richard157! It’s funny that despite several problems with them, you still consider them a good option! I suppose that shows your expectations.

I think ordering through Kaiser has been my fav so far. There was no middle man. I didn’t like Kaiser’s doctors/specialists though, so I guess you just have to pick your poison!


Our Kaiser experience agree’s with you. They wouldn’t let us see a pediatric endo, just a “diabetes trained GP” but ordering/reordering prescriptions and supplies was easy and really nice to be able to work with the company reps directly.

Now we are back with a PPO and have access to amazing physicians but the prescriptions and supplies are painful beyond description. I wish other insurances would make ordering as easy as Kaiser but still let us see great pediatric endo’s.