So I have been dealing with problems getting dd1 diapers since she turned 3 in March. Masshealth will pay for diapers once a child is 3, so I had been waiting for that moment. The day after her birthday dd2 had a doctor's appt so I asked the doctor to write a script for diapers, which she did.
Unfortunately turns out that the doctor also has to write a letter of medical necessary to the insurance and then wait for insurance approval so the doctor's note alone was pretty useless to me.
I returned at the end of March with both kids in toll for their checkups and told the doctor this. The next day I spoke with the nurse who said she got everything all set and sent the script off to the pharmacy. Then I waited.
I knew insurance approval took almost a month so I didn't expect to hear anything for a while. 5 weeks past and dd2 finally went back for her 2 month check up. I asked the doctor what was going on with the diaper order since it had now been 2 months since dd1's 3rd birthday. They said they sent it to a pharmacy called Denmark and gave me the number to call saying once they send it to the pharmacy it is out of their hands.
So I go home planning on calling in a few days, but decided to call that day. Luckily I did, the lady on the phone said that they don't supply diapers and that was that. Now I was really raging. I had been waiting for 5 weeks for insurance approval for diapers that never was. I called back the doctor and told them this. They then wanted me to call the insurance to see what pharmacy they deal with. I am annoyed that I have to do all the leg work and wonder why they don't know what they are doing. She clearly can't be the only kid in the practice on Masshealth and still in diapers.
The insurance told me that the doctor needs to contact medical management and that there was no record of a diaper order being sent to them. I call back the doctors office again for the millionth time and had to continue to wait to speak with the particular nurse that I have been dealing with (for some reason it always ends up being the wrong nurse answering the phone and then it is back on hold I go). By this point I am beyond pissed. I tell the nurse all this and she asks for the insurance number. The next day I get a call saying they sent the stuff to Allcare pharmacy. The good news is this pharmacy has on their website all the steps in the process (wish I would have saw this 2 months ago) and does all the work of contacting the insurance, etc. That was last Thursday.
Tuesday I get a call from the Allcare rep saying they got the doctor's stuff and am sending to the insurance for approval and it takes 14 business days. I thought finally things are starting to happen and in a few weeks I should finally have diapers for dd1.
Well, today (2 days later) everything took a huge 180 degree turn when fedex showed up with 2 boxes addressed to dd1. I thought to myself who sent something to dd1. I open it up and it is 5 packs of diapers! Only problem is it is size 5 and the script was for size 6 (which also are on the tight side so size 5 would definitely not work). I think to myself, wow that is fast, they just got the order last week and sent it to the insurance 2 days ago. Only thing that was confusing was the name on the package was from a totally different place that I had never heard of before.
So I call up Allcare to tell them about the wrong size. They are shocked I got diapers all ready and said that it wasn't from them. They also said that insurance wouldn't approve of 2 pharmacies sending her diapers so now I have an even bigger problem then just a wrong size to deal with.
So I call the number on the script which is in New Jersey. The person who answers asks me where I am located. I say MA, she then transferred me to another company (name unknown), who later tells me they don't know why I got transferred to them since they just handle Rhode Island. Okay so now nobody knows what they are doing. The women said she doesn't know why they sent out 5 packages, saying they usually only send out one the first time to make sure the fit is right. She then said she will send out a size 6 and I should get it in 2-3 business days and will send a label for me to return the 5 size 5 packages (I was hoping she would say just keep them, but I guess not).
So there you have it, I should get a pack of diapers by early next week. Of course, this still leaves the issue about the order from Allcare. The diapers from this company is genetic brand, whereas Allcare said they send out name brand diapers. Of course that involves stopping the order from this pharmacy and praying that insurance doesn't screw up which I don't really want to risk. Seriously as long as the diapers work I don't care for name brand, though it would be nice to get for reward points though. Also the other thing what I don't understand is that the insurance said they never didn't have any record of any order as of last week when I called them so I don't even know if the insurance is even aware or not.
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