Early this morning I set out to a Medicare DME workshop that my employer suggested I attend. Over 150 local and out of state DME providers showed up, small companies like the one I manage, all the way up to the big wigs like Apria and Gentiva. These workshops are supposed to help decrease claim denials and increase your knowledge on reimbursement. What really seems to happen at these workshops for ME however, is I walk away feeling more overwhelmed and depressed about health care today. Or should I say, insurance companies today.
Of course, alot of the DME talk was about supplier reimbursement for Diabetic supplies. Being that I currently manage billing for respiratory and CPAP supplies, I'm not really aware of Medicare's reimbursement guidelines for Diabetic supplies. The things I learned today in regards to this reimbursement just made me-------SICK. There were many times I wanted to leap from my seat and start the whole "real" look into Diabetes talk. I just wanted these people to know! Anyone listening?!! Not that these people knowing the "real" world of Diabetes would change anything, but in my mind I would have felt better if I told them why more than 1-3 test strips a day should be allowed! Yes, today I learned that Medicare only reimburses for 1 test strip per day for non-insulin dependant Diabetics!!!!!!!!!!!!!!!!!!!!!!!!! They are far more generous for Type 1's.....they reimburse for a max of 3 test strips per day. T-H-R-E-E 3...3.....3.....3......3........3.......WHAT?
GAG me. WTF? OMG! I was practically gasping for air listening to the conversations around me. Most attendees it seemed were having issues with reimbursement for Diabetic supplies. Imagine that. After the 9 hours of grueling insight, I'm home with a killer headache. I'm sure my blood pressure must be through the roof. -Sigh- I know healthcare today is joke. I've been working with medical claims my entire life, but somehow hearing all these reimbursement guidelines in a 9 hour convention was just too much for me today. I could go on all day....but I won't.
School day 3 today was great for Maddison! She met a few new friends(which doesn't come easily for her) and was happy as can be when I arrived home. Maddison's blood sugars however, are definitely in the full back to school schedule. Time to get aggressive and figure out the new morning basals! Last night I adjusted basals from
7am to noon, which upped her about 200% in the morning hours. Nothing budged today. In fact, a bit higher by lunchtime.
7:00am 113 Breakfast
7:50am 89 (1 hr PP!!!!) Going into class, no xtra carbs given this time!
10am 190 (3hr PP)
11am 289 (.8 correction w/lunch bolus)
1pm 248 (felt low)
1:50pm 256 (before recess, almost 3hrs PP)
3:16pm 194 (after school)
I dont know what to do. Today I just cant figure it out. An obvious basal issue....but also....what about the .8 correction that did nothing? Is that just because the basal isnt right or is that because a sensitivity needs to change at
11am? I would normally wait 2 days to make any changes....maybe I will. Sometimes it takes a few days to see adjustments make an impact. Why is that if we use a fast acting insulin as our basal? Something to do with metabolism? I just dont have the answer tonight. I'm sure it will come to me in the wee hours of the morning, and then I wont be able to get back to sleep. Ahhhhhh......gotta love back to school!