It helps to have the right tools for the job. Otherwise life can be very difficult and potentially next to impossible. Recently I finally discovered what company my insurance contracts with to supply my feeding tube formula and supplies.
For quite awhile I have been paying out of pocket for it all. One, I was experimenting with what formula I could tolerate and would blend well, and two, I was having a hard time finding the company I needed to contact.
It is quite expensive. and this is a time when my copay is less than I pay 100% out of pocket. This is not always the case. My urinary catheter supplies, it is more cost effective for me to just pay out of pocket. But feeding tube supplies it is more cost effective to pay my copay and go through insurance.
Chronic Illness management is a fulltime job and budgeting and figuring out what is cost effective to go through insurance and what is not is beyond a fulltime job. It seems there is always something.
I was quite excited when we found the right company and my doctor called in exactly what I needed, and the company called to schedule a day to bring out my pump, supplies, and formula.
the day comes and I get a call telling me what time, and I ask to double check that it is the infinity pump, and bags with enfit connections. The gentleman says, it is a Sentinel Feeding pump and this is the only kind they carry. It might be a little bigger than your infinity pump.
I reiterated that no one had told me up to this point you didn’t carry the infinity pump. He has no answer except this was the only pump they carry. I say guess I am going to learn a new pump.
The gentleman gets to my house and brings out this pump that is huge. Not at all mobile in any way. It is heavy and massive. It looks like something that belongs in a hospital. It doesn’t even have a covering over where the tubing goes to protect the tubing from coming loose.
I state, this is not acceptable. My pump runs almost 24/7 because of my gastroparesis, so it has to go wherever I go and this is not in the least bit mobile.
He proceeds to tell me that this is the only pump because all other pumps are obsolete. He is very nice so I don’t want to get nasty, but he is wrong and has been given a lie. There are 3 pumps that have been recently discontinued. That is from Kangaroo, but they have their next generation pump they are now producing and it is not as small as my infinity pump but it is small enough and meant to be mobile and they even make a backpack specifically for it.
Then there is my infinity pump which is still being produced and updated. It is not obsolete at all. What is this guy talking about. I do find out he is new so I give him grace because he has not been trained very well or given the correct information.
Next I ask him what are the bags, what connections do they have. So, he opens one and sure enough the ends are for the old style “traditional” connection. I have the new style “enfit” connections. So even if I could use the pump I couldn’t because the bags are not the right connection. Then I ask to look at the rest of the supplies before he leaves and yes the syringes are not enfit either. So, I am frustrated and he says if he takes it back he will have to write it as refusal. I said, oh no, leave it here because if you say I refused it, insurance will have a fit.
He said he would make a note that they are the wrong bags etc. He didn’t even know the difference between traditional and enfit connections. If you are going to be dealing with feeding tubes and pumps and supplies you should know about the products. It was ridiculous. It was as if they just hired a driver to deliver supplies without educating them on anything.
Immediately after he leaves, I pick up the phone and call. I get a gentleman who also has no clue about feeding tubes or the supplies, pumps, types etc. So we go round and round with him questioning, “now what is wrong with your order?” By the tenth time I ask for a manager to speak to. “oh no ma’am you don’t need a manager I have sent it to the order team. They will get back with you.” I said I would like to speak to a manager. “oh no ma’am you don’t need a manager its all taken care of.
Frustrated I say okay so you are saying I cannot speak with a manager. Am I understanding correctly you are not connecting me to a manager.
“Yes ma’am you don’t need a manager. I sent it to the order team.”
I said, “what is the timeframe. when will I hear from the order team?” I don’t know ma’am.
I need to know a timeframe because this needs to be taken care of now as I rely on my feeding tube for nutrition. How many days will the team get back to me. General timeframe.
“As soon as possible ma’am.”
So, am I hearing correctly you do not know a general timeframe.
“yes, ma’am.”
So do I just keep calling back checking?
Yes, you can keep calling back to check on your order.
I said thank you, and I got off the phone fuming and very frustrated. that phone call told me this was potentially going to be a long battle.
Wild, about an hour after that I receive an email asking me to take a survey letting them know how they did today? It was one question with an answer of 1-5, 1 being terrible and 5 being best. I scored a 1. and then it asked me to elaborate and so I wrote exactly what was wrong.
Interestingly enough within an hour I received a call. It was a branch manager wanting to know more about what happened today? I repeated the entire thing again including what happened with the phone call, and he said, “oh I am so sorry, that is not right. It should not have been handled that way.”
He then asked what pump etc I use and he said we absolutely can get you what you need, the gentleman must have been mistaken but we can correct it.
I said thank you, and took it with a grain of salt while holding out hope that he would be true to his word.
You know what? He was. The next day another technician came to my house with an infinity pump and supplies. My formula arrived via UPS and then enfit syringes also came via the mail.
I felt lucky that I didn’t just delete the survey. I felt sad that me calling the support number didn’t get anywhere, but boy howdy that survey sure got attention. They called me within an hour asking about the survey and what happened.
I am so glad the branch manager, whatever that means, but he knew the products and said of course we can get you what you need? Then why didn’t they follow that in the first place? My doctor sent in the order for my exact needs. They had all the info.
Not like the 2 pumps are that much different in price. they are pretty much the same. if buying retail. But they serve very different functions.
This is why I encourage people to be the squeaky wheel and be your best advocate or someone close to you help. It takes being the squeaky wheel and not accepting no for an answer. I was prepared to take this all the way to the Ombudsman? or State Insurance something? I can’t remember but there is a process you can take beyond company and insurance to make the ultimate appeal in order to get what you need.
Sorry I cannot think of it and I am too tired to look it up at this point.
The only reason I have what I need is because I stood up for myself. I clearly stated that what they bought initially was unacceptable. And I didn’t stop, and who knew that the little survey would be so important to the story.
lol. moral of the story, take the little surveys, you never know how important they are.
Truly, please speak up for yourself. Do not accept the unacceptable. Life is hard enough, and not have the right tools for the job makes it even that much more difficult.
paint much love, always,
Connie Karleta Sales
a.k.a. This Crooked Little Flower