Choosing An Insulin Pump: The Jedi Returns.

Guess what finally happened yesterday?

OH MY GOD OH MY GOD OH MY GOD INSULIN PUMP APPROVED!!!!! (Me: http://t.co/sapAZ8t7wj)
— Kim / Diabetes (@txtngmypancreas) December 30, 2013

I think the image I linked to it that tweet got lost, so here's a similar one for reference:

SO FREAKIN' EXCITED

I had been pestering calling the CareCentrix (my DME provider; henceforth abbreviated as "CCX") rep just about every day since my case was reopened, and yesterday she finally got to call me with the good news that my request for a new insulin pump was approved. It was a bumpy and anxiety-ridden ride for me that was full of tweets, emails, and phone calls. In short: I had to be loud, persistent, and relentless, as well as my endocrinologist providing additional information of many different varieties.

@Cigna and CCX say they've reached out to my endo 4x re: insulin pump appeal. My endo hasn't received anything. Getting frustrated.
— Kim / Diabetes (@txtngmypancreas) December 17, 2013

To Cigna and/or CCX's credit, they did (for the most part) do a good job of keeping in contact with me. Most emails to Cigna customer service were responded to the same day, and the rep from CCX also gave me her direct extension so that I could call her any time I had a question or concern, which I did quite often. (By the end of it, I had her extension memorized!)

But to stay on topic, no new news yet. The clock is ticking - warranty is up in 9 days. I am trying not to panic.
— Kim / Diabetes (@txtngmypancreas) December 20, 2013

According to CCX, it was my endo's office that contributed to a lot of the delay. I don't know whether that's true or not, but with all of the requests CCX made of my endo's staff (fax records, answer these questions, now fax other records, now we need a letter from you explaining why she needs this, now we need to know what's wrong with her pump AGAIN....) and a short-staffed office that is no doubt bombarded at this time of year with last-minute requests, I can understand why it would take some time. Still, I was filled to the brim with anxiety and frustration.

My frustration with CCX is turning into frustration with my endo. Weeks go by, no add'l info provided. Won't return calls. #InsulinPumpSaga
— Kim / Diabetes (@txtngmypancreas) December 27, 2013

I think if you'd test my blood pressure right now, the machine would just lay down and melt. #InsulinPumpSaga
— Kim / Diabetes (@txtngmypancreas) December 27, 2013

And then, a breakthrough!

Just heard back from endo. They faxed everything over to CCX this morning. C'moooooon, CCX! Ball in your court! #nowhammies #InsulinPumpSaga
— Kim / Diabetes (@txtngmypancreas) December 27, 2013

Called CCX to confirm faxed docs were received from my doc; got voicemail. Emailed @Cignaquestions to follow up. #InsulinPumpSaga
— Kim / Diabetes (@txtngmypancreas) December 27, 2013

Confirmed that CCX rec'd endo's info; has been flagged for "expedited review". One step closer; stress level down to 10.2. #InsulinPumpSaga
— Kim / Diabetes (@txtngmypancreas) December 27, 2013

But who knows how long their "review" would take, and I could just imagine that it would conveniently require time into the New Year to complete, which is when our deductibles would reset (and I would be responsible for the balance of the cost insurance wouldn't cover).

This is when I may have gotten a little sassy, but you know what? That gets stuff done.

Email to @Cignaquestions unanswered; call to CCX rep goes to vm. Hope those employees enjoy time off. My health doesn't take a holiday tho.
— Kim / Diabetes (@txtngmypancreas) December 30, 2013

Shortly after I tweeted that, the nurse at my endo's office called. "Your insurance just called, and asked about your pump. So tell me again what's mechanically wrong with it?" I repeated myself for what seemed like the tenth time: the housing is scratched, and the buttons are not as responsive as they should be. "I'll press a button, but it doesn't always recognize that I did, the first time. I have to press it a second time for it to register."

"Ah, okay. Perfect. I'll call her right back. Thanks!"

And a couple of hours later, I got a call from CareCentrix. It was the nurse who had been reviewing the "audit" (I shouldn't call it an "appeal", but "audit" is okay? Whatever you want to call it is fine, just approve the darn thing), and I have to believe this is her favorite kind of phone call to make.

"Hi, Kim? I'm an RN with CareCentrix and have been the one reviewing your file - I spoke with a nurse at Dr. [name redacted]'s office this afternoon, and she was able to provide the last of the information we needed while completing your audit. I wanted to verbally let you know that your request for an insulin pump has been approved."

I made a noise that can't really be recreated, except by the combination of relief, exhilarating joy, and delicious victory.

Being that it was the second-to-last day of the month, my next question was, "So what is my next step to moving this along? Do I contact the pump company?" "I will fax over the authorization documents in the next few minutes here, so they actually haven't received them yet - give me 10 minutes or so, but yes, if you have a direct contact with them, you could call and tell them to look out for my fax." Whoopee!

No sooner had I hung up with the CCX nurse than I was on the phone again, asking if an authorization had been received yet. It hadn't, and the pump rep and I have been in contact back-and-forth since then, getting everything in place. There's still some panic in my system as this is really down to the last possible moments, but she assured me that she would "get this to you even if I have to drive it to you myself". Ha!

So, by now you may be wondering which pump I ended up going with - since the order hasn't technically been placed yet, I'm not real comfortable disclosing that at this time. It doesn't feel real yet! But once the order has been placed, I'll let you guys know.

For now, I'll be relishing in the feeling of finally having "won" the right to own one of the medical devices that helps me stay healthy.

Huzzah!!

UPDATE: The pump is now ordered, so I can feel okay telling you: I ordered a t:slim. If you're  wondering why I ended up going with it over staying with Animas or switching to the Snap... 

I'll explain my thoughts on Snap later this week(tl;dr: I love it, but it's missing a couple of features that are super important to me, personally), but it comes down to t:slim having the features most important to me, that the other two pumps just don't offer at this time. I think the Ping is a great pump, and doing the trial with a Snap pump was a pleasant experience, but for what I need right now t:slim seems to be the best fit. More on that later.