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Continuous Glucose Monitors (CGM’s) are quickly becoming an invaluable alternative for patients who are looking for alternatives to optimize their health. A CGM is a device that sends readings about the wearer’s blood sugar levels to an app, allowing the wearer to make real-time adjustments to their activity level or food consumption based on their own body’s data.

As healthcare organizations have seen the efficacy of putting this information in their patient’s hands, insurance companies have broadened their requirements to cover devices for people without requiring the use of insulin.

Working with your Doctor, if they feel you meet the new requirements for this device, let’s explore coverage through your insurance plan before you pay out of pocket! It all starts with a Prescription from your Doctor. Here’s what you can expect:

• Hart Medical will receive a prescription from your doctor with supporting documentation from your medical history.
• A customer service expert from our CGM team will reach out to you via phone, and confirm some basic details with you, so that once qualified we know where to ship your device.
• They will talk to you about your preferred ways to be contacted in the future for supplies to support your device.
• The paperwork needed to bill your insurance will be emailed to you by the customer service expert you are working with.
• The CGM is made up of a few parts. The receiver (a device or an app storing all the data), as well as disposable sensors that go into the device you wear. Some brands also use a transmitter (this connects to the sensor). Enough sensors are provided to wear for 90 days at a time, reducing the amount of chatter you will hear from us down to just 4 times a year to keep your device running smoothly.
• Our expert will review your benefits, apply for prior authorization with your insurance company if needed, and provide the details back to you about what we expect your insurance company to pay for the CGM device and sensors; and give you options to manage your out-of-pocket costs.
  • One option that our CGM patients find the most helpful is our Autopay Program. Patients select a monthly payment that they can afford if needed and place a card on file. If the insurance passes costs down to you, then only the agreed monthly payment will be charged, regardless of the balance owed. This has been a great way for our patients with high deductible plans to get into CGM service but manage the expense over a period of time.
•  Our customer service expert will go over exactly what we are shipping and enroll you in the reorder system, so that you will be prompted by an automated call just before your supplies are due to run out.
• Insurances require that you check in with your doctor every 6 months to ensure that you are using and benefiting from therapy from a clinical standpoint.  

Are you considering a CGM Device? We’d love to hear from you! You can have your doctor send a request to our team by faxing us at (248) 353-4260.