Federal Oversight Agency

(Monica) #1

Does anyone know the federal agency that would have oversight over Dexcom? I spent 50 minutes on the phone today, with 42 of those minutes on hold, trying to get answers on why my insurance carrier and doctor have yet to receive the necessary paperwork to complete to §reauthorize me to use the G6, even though I started the process 16 days ago. This is my 4th call in that timeframe, and I have yet to receive any kind of answer. I’ve had it with their incompetence, and feel a formal complaint to an oversight agency is necessary. Thanks!

(joe) #2

@MonicaM hi Monica,

The FDA is a federal agency (food & Drug) but it only deals with medical device safety and adverse reactions for a licensed product such as the G6

The SEC is a federal stock oversight (Dexcom Inc is a public traded stock on NASDAQ) but only deals with the incorporation legalities

So what’s left is business. There’s no federal oversight for bad business unless they stole money from you, systematically, and over state lines. I know it’s not helpful but I can’t think of anything else.

re-authorizations, in my limited experience with pumps and CGM, are a matter of a prescription, written (originating) at your doc, going to the medical supplies pharmacy or directly to Dex. Maybe I am wrong, but this should originate from your doctor in the form of a written order?

A ploy that works for me is to pretend I am a new customer, “considering” a ___ (whatever product). It seems that sales representative people know all the hidden doors sometimes.

anyway this is sad to hear, hope they find the log-jam and you get your stuff quickly.

(Dennis J. Dacey, pwD) #3

Hi Monica @MonicaM, I echo what @Joe says about dispensing a prescription ONLY device such as a continuous glucose monitor. Before anything can be done, your doctor must write a prescription for you. Very similar to you walking into a drug store and saying I want to buy a 90 day supply of “Controlled-drug zzz”; the clerk or pharmacist will say, “Do you have a written prescription from your doctor?”.

To speed things up, you or your doctor could go on–line to the “providers” section of the DexCom website and get the form specific for a glucose monitor; very simple. Also, if you are expecting an insurance company to pay for this device, there are necessary forms there that your prescribing physician must eventually complete. I don’t know if you are a medicare beneficiary, but if you are don’t expect to get a G6 until at least the fourth quarter of this year; yes, I know CMS approved the G6 for Medicare Beneficiaries on October 16, 2017, but delivery has been delayed for about a year.

Good luck, hope you get something soon. And just to be prepared, your insurance carrier may be asking you to supply about 90 days data of your attempt at diabetes management plus certain lab test results.

(Monica) #4

Here’s what’s happened: I called on 3/14 to reorder sensors and transmitters, and was told I needed to wait a few more days to order. So, I called again on 3/20. Then was told of the need for documentation to re-preauthoize (mind you, I’ve used Dexcom for 2.5 years). So, I wait a few days and then get ahold of my doctor to ask them to promptly complete paperwork. They haven’t received anything from Dexcom. I call Dexcom again on 3/27 - they’re still awaiting some paperwork, so I call my insurance carrier - they haven’t received anything from Dexcom. So I call Dexcom again on 4/1, and talk to someone in the insurance area. They are awaiting paperwork. When I point out that neither my insurance carrier nor my doctor have received the paperwork to complete that they’re allegedly awaiting, I’m transferred to a customer service rep who tells me she’ll get this over to the department that needs to send out the paperwork (the insurance department that transferred me to her). I’ve gotten nothing but the run around. Meanwhile, I’ve been out of sensors for over a week and my transmitter is getting ready to expire. And I have hypoglycemic insensitivity.

(steve) #5

Unfortunately, with chronic illnesses like T1D there is red tape and bureaucracy everywhere. I have had run arounds with Dexcom, other medical supply houses and the pharmacy especially when going through mail order. There is no agency that is going to help you with that. Try to get as high up in the organization as possible asking to speak with a supervisor or senior team member. Document who you spoke with, when, and request your conversation and action items be documented in their system so you don’t have to start over every call. I had an order issue with Dexcom which was so bad that I went on LinkedIn and sent their CEO Kevin Sayer a connection request so I could email him directly with my experience. To his credit he accepted. He never responded, but after I placed a recent order I received a follow up email asking for feedback on the order experience. Hadn’t had that previously. May be unrelated, but I like to think he took action.

(Tina) #6

Go with the Freestyle Lybre. Much better service. Dexcom dropped the ball for us as well.

(brighter1085293) #7

Both Dexcom G6 and Freestyle Libre are available from local pharmacies and Costco pharmacies have special pricing on sensors and transmitters. The local option can serve as a contingency for supplies during the annual insurance authorization hurdles. This may mean paying “out of pocket” (about $100/sensor for G6, $40/sensor for Libre) and then being reimbursed or using funds from a Health Spending Account (HSA)/Flexible Spending Account (FSA). If your health insurance is from an employer, consider complaining to the HR department about the delay and risk caused by the ridiculousness of a reauthorization process for a chronic condition for which there is no cure. If you have a healthcare marketplace plan, consider complaining to your state insurance commission.

If you haven’t used Libre before, please be aware that the Freestyle system does not provide alerts for hypoglycemia. Based on my own use and opinion from that use, Libre is intended to replace finger-prick testing and it can’t alert you to risks like nocturnal hypoglycemia.

Finally, I suggest asking Dexcom for the name and contact information of your local Dexcom sales person. The local representative can be a lifeline during these kinds of frustrating misadventures.