Navigating Your Way to Better Diabetes Management – Getting Started

Now that you have decided to include continuous glucose monitoring as part of your daily diabetes management program, you can begin the process of obtaining a FreeStyle Navigator^® Continuous Glucose Monitoring System. To assist you through this process, Abbott Diabetes Care (ADC) has developed a Resource Center to help you determine whether or not your health insurance plan covers this product and to provide information on the distribution process. For your convenience, we have included all materials necessary to initiate the process for accessing the FreeStyle Navigator system in your “Introduction to FreeStyle Navigator” literature packet. Please complete the following four steps to expedite the process for obtaining your FreeStyle Navigator system:

Step 1:

Complete and sign the Authorization to Release Patient Information.
The Authorization to Release Patient Information gives ADC permission to contact your insurance company and physician on your behalf.

Download Form: Authorization to Release Patient Information

Step 2:

Complete and sign the Patient Information Questionnaire.
All information is personal and confidential. The Patient Information Questionnaire provides us with the details we need to assist you.

Download Form: Patient Information Questionnaire

Step 3:

Obtain a completed Statement of Medical Necessity from your physician.
The Statement of Medical Necessity is a document completed by your healthcare provider, which functions as the prescription and provides key information about your medical history necessary to justify why the FreeStyle Navigator system is an appropriate therapy for you. In some cases, your healthcare provider may submit this on your behalf.

Download Form: Statement of Medical Necessity

Step 4:

Submit this information to the ADC Resource Center by Fax or Direct Mail.

Fax:
 Attention: ADC Resource Center, 1-888-423-2435
    
-OR-
 
Direct Mail:  ADC Resource Center, P.O. Box 1087, San Bruno, CA 94066

As soon as you have completed this information and it is received by the ADC Resource Center, an ADC Resource Counselor will contact you directly to discuss how you wish to proceed. The Resource Counselor will work with your health insurance plan to determine the level of coverage for this product. All paperwork, including a Statement of Medical Necessity, must be received by the ADC Resource Center prior to initiating the insurance verification process.

Following these initial steps will allow Abbott Diabetes Care to contact your healthcare professional and insurance carrier. Our primary objective is to make the process of accessing the FreeStyle Navigator system as simple as possible for you.

If you have any questions about the forms to be completed or additional questions about the insurance coverage process, please contact Abbott Diabetes Care at 1-877-4ADC-INFO (1-877-423-2463).

Note: By completing these forms, you are giving Abbott Diabetes Care and any designated Durable Medical Equipment (DME) supplier permission to contact your insurance company to review your benefits and your physician to discuss your medical need of necessity for a continuous glucose monitoring system. This does not obligate you to obtain a FreeStyle Navigator system.

Customer care available 24 hours a day, 7 days a week: 1-866-597-5520