Does My Insurance Cover Diabetes Education
Nationally Recognized Four Day Session
Basic Skills Class - 8 Hours
Pre-Diabetes Class
Support Group
Services


Does My Insurance Cover Diabetes Education

Does My Insurance Cover Diabetes Education?

Probably! But it is crucial to your financial and physical health that you determine how your health insurance coverage pays prior to service.

Education is vital for good diabetes management. We strongly encourage all people with diabetes to become very familiar with their insurance coverage for diabetes education. First, you may have benefits you don't know about and aren't using! On the other hand, you may have limits to your diabetic education coverage and need to design your diabetes education management plan accordingly.

Here at the Diabetes Education Center of the Midlands, we are happy to help guide you through the process of checking your insurance benefits for diabetes education. However, it must be your priority and your responsibility to understand your own insurance plan!

Here are some easy tips onhow to best approach your insurance provider for an estimate* of your diabetes education benefits.

  1. Call the customer service number listed on the back of your insurance card.
  2. When prompted, select benefits and eligibility.
  3. Ask for and record the name of the representative you are working with and the time and date you contacted that represented. Again, we advocate you becoming as empowered and knowledgeable as possible. Keeping detailed notes of all health insurance matters is a sure step in the right direction!
  4. Ask, "How is my diabetic education covered?" Diabetes education is billed either as G0108, G0109 or 97802 and 97803. Enquire about each number and, again, write down the response. Frequently, your education is subject to satisfaction of your deductible and coinsurance.
  5. Know if you have a copay for an office visit with a specialist and, if so, how much. Again, write that down!
  6. Be sure to enquire about any limits to your diabetic education. We frequently see a monetary limit (say $250 in one year) or visits limited by number (4 per year). Some plans, Medicare for example, have a once per lifetime benefit! So, you wouldn't want to waste your benefits on a provider who is not certified or also a class that is not comprehensive.
  7. If you do have a limit on your benefits, the representative should be able to tell you how much of the benefit you have used or have remaining.
  8. You must know whether or not your insurance plan requires preauthorization. If preauthorization is a feature of your plan, we are happy to obtain a preauthorization for you.

That's it! With these simple steps you will get an understanding of your health benefits for diabetes education! You must know how your health insurance will assist you in your diabetes management. So save yourself headaches and financial surprises and contact your insurance representative for an estimate* of your benefitstoday! (Don't forget a pen and paper!)

COMMON INSURANCE TERMS YOU SHOULD KNOW

deductible- An insurance deductible is the minimum amount the patient must pay before the insurance company will pay anything toward charges. Know whether or not you have a yearly deductible. If so, when does it reset? Do you have any fourth quarter carryover (ie payment toward deductible from the final quarter of the year prior?)

coinsurance- This simply is the percentage amount you are required to pay towards your health insurance bill when you file a health insurance claim. The coinsurance percentage is usually in addition to the deductible that would need to be paid first before the insurance company would pay anything. Common coinsurance amounts are 80/20 or 90/10 (the company pays 80 percent and you pay 20 percent) but can vary widely by individual plan.

copayment- While a copay is essentially the same thing as coinsurance in that it is the capped contribution an individual must make for a medical service, many people think of a copayment only as the fixed amount they pay per visits with a doctor or specialist. For example, say you pay say $20 to see your doctor, the insurance company will pay the remainder.

coinsurance max- The maximum coinsurance you pay before a health plan begins paying at 100% of your covered medical expenses. This is generally a calendar year maximum and common coinsurance maximus are $2000.00, $2,5000 and higher. Again, know the details of YOUR PLAN!

limits- Simply, any limitation or exclusion to your health care coverage. It is wise to know your limits, if any!

precertification or preauthorization-Services that must be coordinated and approved by your healthcare management program to be fully covered by your plan. To avoid a reduction or denial of benefits, members must precertify. Know if your plan requires preauthorization for ANY service.
*Insurance providers are very careful to state that the benefits estimate they provide is only an estimate and actual coverage cannot be determined until a claim is filed.

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Nationally Recognized Four Day Session

Nationally Recognized Four Day Session

COMPREHENSIVE TREATMENT AND TRAINING PROGRAM

2010 DATES

January 11-14, 2010 4:00-8:30 PM

February 8-11, 2010 4:00-8:30 PM

March 1-4, 2010 1:00-5:30 PM

March 22-25, 2010 4:00-8:30 PM

April 19-22, 2010 4:00-8:30 PM

May 10-13, 2010 1:00-5:30 PM

June 1-4, 2010 4:00-8:30 PM

June 28-July 1, 2010 4:00-8:30 PM

July 19-22, 2010 1:00-5:30 PM

August 16-19, 2010 4:00-8:30 PM

September 7-10, 2010 1:00-5:30 PM (Tuesday-Friday)

September 27-30, 2010 4:00-8:30 PM

October 25-28, 2010 1:00-5:30 PM

November 15-18, 2010 4:00-8:30 PM

December 13-16, 2010 1:00-5:30 PM

For more information and to receive an approximate cost with your insurance coverage:

Please contact Annie at (402) 399-0777 ext 230 -email annie.n@diabetes-education.com

You must register to attend!

A four-day, in-depth course focusing on treatment and management methods to promote health for those taking insulin as well as Type 2 individuals struggling on oral medications.

  • Daily Endocrinologist Consult
  • Daily Certified Diabetes Educator Registered Dietitian Consult
  • Daily Medication Adjustment
  • Daily Certified Diabetes Educator Registered Nurse Consult
  • Exercise Physiologist Session
  • Daily Blood Glucose Analysis
  • Daily Medication
  • Lipid Profile
  • Hemoglobin A1C
  • Immunoassay for Microalbumin
  • Blood Glucose Monitor Assessment
  • Basic, Plus Advanced Training (32 hour program) - see sample schedule
At the conclusion of the program a detailed report is sent to each patient's primary physician to ensure continuity of care.

Sample Schedule

Learning To Live Well With Diabetes

Comprehensive Treatment & Training Program

All lectures and interviews are conducted by physicians, diabetes nurse educators, registered dietitians, and an exercise physiologist. This program includes individual medical management with a physician specializing in diabetes care and certified diabetes educations (RN & RD).

Day 1

  • Individual Consultations with Endocrinologist, Nurse and Dietitian
  • Overview of Cause and Treatment of Diabetes
  • Monitoring Diabetes Control and Understanding Essential Lab Tests
  • Meal Planning and Carbohydrate Counting
  • Blood Glucose Monitoring Lab

Day 2

  • Individual Consultations with Endocrinologist, Nurse and Dietitian
  • Medications for Blood Glucose Control
  • Nutrition: Its Role in Diabetes Management
  • Exercise - A Tool in Diabetes Management
  • Resources: Recipes, Cookbooks, Food Guides, Snack Ideas
  • Pattern Control - Balancing Food, Activity, and Medications

Day 3

  • Individual Consultation with Endocrinologist and Nurse
  • Dining Out and Ordering from Menus/Alcohol Use Guidelines
  • Insulin Pump Therapy (Optional)
  • Recognition, Treatment & Prevention of Low Blood Sugars
  • Taking Care of Your Skin and Feet
  • Label Reading and Grocery Shopping Tips
  • Travel Tips
  • Long-Term Complications of Diabetes
  • Ketoacidosis
  • Managing Diabetes on Sick Days

Day 4

  • Emotions/Coping with Diabetes
  • Modifying Fat Intake
  • Planning Your Exercise Program
  • Balancing Food and Insulin with Extra Activity
  • Stress and Diabetes
  • Community Resources
  • Making Your Treatment Plan Work (Goal Setting)
  • Standards of Care
  • Hope for the Future (Research)
  • Individual Exit Consultations with Endocrinologist, Nurse, and Dietitian

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Basic Skills Class - 8 Hours

8 HOUR BASICS SKILLS CLASS

2010 DATES

  • January 18 & 21, 2010 (Monday & Thursday) from 1:00-5:00 PM Follow-up Tuesday February 23, 2010 from5:00-6:15 PM
  • February 1 & 4, 2010 (Monday&Thursday) from 5:00-9:00 PM Follow-up Tuesday March 30, 2010 from 5:00-6:15 PM
  • February 15 & 18, 2010 (Monday & Thursday) from 1:00-5:00 PM Follow-up TuesdayMarch 30, 2010 from 5:00-6:15 PM
  • March 8 & 11, 2010 (Monday & Thursday) from 4:00-8:00 PM Follow-up TuesdayMay 4, 2010 from 5:00-6:15 PM
  • March 29 & April 1, 2010 (Monday & Thursday) from 5:00-9:00 PM Follow-up TuesdayMay 4, 2010 from 5:00-6:15 PM

For more information and to receive an approximate cost with your insurance:

Please contact Annie at (402) 399-0777 ext. 230 - email annie.n@diabetes-education.com

You must register to attend!

Session 1 (4 hours):

  • Registration
  • Diabetes Overview: Prevalence, Diagnosis, Type 1, Type 2, Symptoms, Treatment Overview
  • Monitoring Diabetes Control
    Blood sugar goals, glycosylated hemoglobin
  • Dietary Management
    ADA recommendations for calories, carbohydrates, protein and fat
  • Meal Planning Methods (Carbohydrate Counting) and Label Reading
  • Individual Meal Planning
    Carb distribution, keeping 24 hour food diary
  • Medications for Blood Sugar Control
    Insulin: types, action times, standard vs. intensive regimens
    Oral Medications: actions, side effects, combination therapy
Session 2 (4 hours):
  • Benefits of Exercise: Effect on control of blood sugar, weight and blood pressure
  • Planning Your Exercise Program
  • Low Blood Sugars - Symptoms, Cause & Treatment
  • Chronic Complications: Disease of blood vessels, kidneys, eyes and nerves
  • Preventing Complications: Standards of medical care, self-care goals, foot care guidelines, stress management, understanding lab tests
  • Review of Food Records and Blood Sugars (Looking for Patterns)
  • Changing Behaviors Tips and Coping Strategies: Write behavior change objectives

Topics To Be Discussed:

  • Overview of Diabetes
  • Monitoring Blood Sugar Control
  • Diabetes Medications
  • Dietary Management including Meal Planning/Label Reading
  • Role of Exercise
  • Prevention of Complications
  • Behavior Changes
  • Pattern Control

Participants are eligible to receive a Free Blood Glucose Meter & Training!

Many insurance plans may cover the cost of the class.

You must register to attend, call 399-0777 ext. 230 for details

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Pre-Diabetes Class

A program designed for those who are at-risk of developing diabetes or are interested in weight loss.

Each three-session program will focus on preventing Type 2 diabetes.

2009 Pre-Diabetes Class Dates

  • January 27, February 3,& 17 from 5:00-6:00 PM
  • March 10, 17, & 31, 2010 from 5:00-6:00 PM

Cost of 3-session program: $45

What You Will Learn
Simple Food Plans
Easy Exercise Tips
Practical Steps to Reduce Risk Factors
Motivation Techniques

For more information, please call Annie at 399-0777 ext. 230 - email annie.n@diabetes-education.com

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Support Group

"Living Well With Diabetes" - Free Educational Support Group

  • Meeting Time: 10:00 AM to 11:30 AM (Second Saturday of Every Month)
    11:30 AM to 12:00 PM Wellness Workshop will follow...
  • Meeting Location: Diabetes Education Center of the Midlands
  • 2910 South 84th Street (East Bay in Frederick Square Plaza)

For directions and more information, contact Elliot Brown at (402) 399-0777 or e-mail at ebb75@cox.net

ALSO There is a new group to join if you're 18 and have Type I Diabetes!

  • Meeting Time: 10:00 AMto 12:00PM(Third Saturday of Every Month)
    11:30 AM to 12:00 PM Wellness Workshop will follow...
  • Meeting Location: Diabetes Education Center of the Midlands
  • 2910 South 84th Street (East Bay in Frederick Square Plaza)

Contact: Joan Nguyen (pronounced Joanne Win) at (402) 312-5782 (call or text) or email at joan_bug@hotmail.com (subject Type I).

Also bring a friend!

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Services

One-to-One Services

The following is provided by a Registered Nurse nationally certified as a diabetes educator:

  • insulin administration
  • overview of diabetes - causes and treatment
  • benefits of diet and exercise
  • recognition and treatment of low blood sugar
  • management goals
  • blood glucose monitoring - target ranges
  • skin care and hygiene needs
  • benefits of good blood sugar control
  • pattern control
  • avoiding high blood sugars

The following is provided by a Registered Dietitian nationally certified as a diabetes educator:

  • diet history
  • evaluation
  • meal plan instruction
  • nutritional management
  • label reading
  • grocery shopping
  • dining out

Insulin Pump Initiation

Certified Pump Trainers will take you through pre-pump education, starting you on your pump and following up to assure a successful experience. For details about pump education education program call (402) 399-0777.

Weight Management Consult

An individual consultation with a registered dietitian devoted to assisting individuals in weight reduction through personalized intervention.

Community Resource Center

Housed in DECM, the resource center will provide up-to-date educational materials, pamphlets, videos, computer links and blood glucose downloading capabilities to serve the entire community. A lending library and equipment loan program will also be available.

Quarterly Newsletter

With a mailing list of over 7,000 DECM Newsletters address current issues and management topics.

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Diabetes Education Center of the Midlands
info@diabetes-education.com
2910 South 84th St.
Omaha, NE 68124
1-800-779-3374

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