CCS Medical

Questions for Insulin Pump Patients:

We are an insurance based provider; we work closely with your
insurance company and your doctor to provide your supplies.

Do you currently use insulin? *
Yes No

Are you currently on insulin therapy or CGMS (Continued Glucose Monitoring System) or none? *
Insulin Therapy CGMS No

Has your physician discussed pump therapy or CGMS? *
Yes     No

How many times do you test your blood sugar and inject insulin?

Test blood sugar    *

Inject insulin:    *

Last date you received pump supplies? *

When was the last time you visited your physician office to have your diabetes evaluated? *

IMPORTANT NOTE:
For traditional Medicare Fee for Service insurance, effective July 1, 2016,
CCS Medical will no longer be able to provide diabetes test strips, lancets, lancing devices or control solution
due to Medicare’s National Mail Order Competitive Bid program.

This does NOT impact our ability to provide insulin pumps and supplies, wound care supplies, urological supplies, ostomy supplies, or orthotics.
CCS Medical does accept Medicare for these items.
In addition, we accept commercial plans, Medicare Advantage plans managed by private insurers, traditional Medicaid, and Managed Medicaid.

If you are interested in ONLY diabetes test strips, lancets, lancing devices and control solution,
visit your local retail chain pharmacy for assistance in obtaining these supplies through your Medicare Part B benefits.

Questions for Diabetes Patients:

We are an insurance based provider; we work closely with your
insurance company and your doctor to provide your supplies.

Do you have a current and valid insurance card with Medicare, Medicaid, or a commercial insurance? *
Yes     No

Has a physician diagnosed you with diabetes? *
Yes     No

Have you seen this physician in the last six months? *
Yes     No

What brand of test strips do you currently use? *

Medicare Beneficiaries: Currently we do not supply Abbott or Bayer products. To find a contracted provider who does carry your product, visit www.medicare.gov/supplierdirectory or call 1-800-MEDICARE. Otherwise CCS Medical would be happy to supply your diabetes testing needs if you would like to try a different brand.

Questions for Wound Care Patients:

We are an insurance based provider; we work closely with your
insurance company and your doctor to provide your supplies.

Do you currently have an open, non-healing wound? *
Yes No

Are you currently being treated by a physician for your wound? *
Yes No

By checking this box, you agree that you wish to be contacted by CCS Medical regarding products, services, or other useful information described on this website. CCS Medical may call, email, or text you by using the contact information you’ve provided, which may include prerecorded communications, SMS messages, and automatic dialing systems. You do not need to provide this consent in order to purchase any products or services (although informational messages may be required to use certain services). Your telephone carrier’s standard message rates may apply to these communications. You can tell us you no longer wish to receive these communications at any time.

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We are required by law to maintain the privacy of protected health information.

Click here to read our Notice of Privacy Practices

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