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Insulin Pump Requirements

MEDICARE OR MEDICAID

  • C-peptide and FASTING Glucose drawn concurrently (Fasting glucose must be >225 for approval).

  • C-peptide for Type 1 and Type 2 must be 10% of the lower reference range (i.e. Reference range is 1.0-3.0 then the labs must be 1.1 or lower).

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PROVIDENCE INSURANCE - *NEW* TO PUMP THERAPY

  • C-peptide and FASTING Glucose drawn concurrently (Fasting glucose must be >225 for approval).

  • C-peptide for Type 1 and Type 2 must be 10% of the lower reference range (i.e. Reference range is 1.0-3.0 then the labs must be 1.1 or lower).

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COMMERCIAL INSURANCE ON PUMP SWITCHING TO MEDICARE OR MEDICAID

  • C-peptide and FASTING Glucose drawn concurrently (Fasting glucose must be >225 for approval). 

  • C-peptide for Type 1 and Type 2 must be 10% of the lower reference range (i.e. Reference range is 1.0-3.0 then the labs must be 1.1 or lower).

 

NOTE: Patients must contact their DME Supplier to initiate a new order/authorization request if patient updates their insurance plan.

ALSO

C-Peptide and Fasting Glucose lab results do not expire and may be reused.

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Clinic: 503-297-3336

Scheduling: 503-274-4880

Billing: 503-274-4808 

Scheduling: 801

Medical Records: 802

Billing: 803 

Prior Authorizations: 808

NP Coordinator: 328

Fax: 503-297-3338   

NP Records Fax: 503-972-7573

Lab Fax: 503-292-1948

MA Fax: 503-296-8632

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9135 SW Barnes Road, Suite 985

Portland, OR 97225

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portal@pdec.org

 

These will forward to Spencer and he will distribute appropriately

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https://pdec.org/​

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