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RE: [IP] Help, Michael...



Roslea, 
There are a lot of different experiences on this list of dealings with the
insurance company about the pump.  I had a coworker at my last job who got
one without any trouble and the rumor was the same about them only approving
"brittle" diabetics.  He really didn't fall under that category at all.  

At my new job I have an amazing insurance company that approved me in under
20 hours.  I faxed the Rep the Insurance information form.  She called the
doctors office for the script and letter of recommendation which they faxed
over and she faxed it to the insurance company.  20 hours after I faxed the
Rep the Insurance info I got a call from the MM Insurance department saying
I was approved and what color did I want. :)
Had the pump 5 days later.  The reason was it was approved Oct. 29th and
they wanted to hold off shipping it after Oct. 31 because of the change of
time error.  Now I'll admit this is incredibly rare, I was all set for a
fight and didn't have one. 

I later learned that 2 years ago a patient of my doctor who had this
insurance, was having problems getting her pump approved.  So she started
doing research.  She found that one of the chairs in the company was a Type
I and started "informing" him about the wonders of pumping. :)  She was
relentless in trying to convince him that this was the best choices out
there.  Months later she received approval in the mail.  Turns out the guy
went out and got himself a pump because of her convincing and pushed to
change the company policy on approval.  So fights can be won!

In the case of this company, they payed for my pump 100% and it wasn't
considered durable medical equipment.  All my other supplies are fully
covered under durable medical equipment...and I don't forsee they ever
getting near the currently set "yearly" cap.  

Best of luck,
Sherry

-----Original Message-----
From: Sam Skopp
To: email @ redacted
Sent: 12/5/99 1:43 PM
Subject: Re: [IP] Help, Michael...

At 10:29 AM 12/5/1999  RoseLea wrote:
 >Hi Michael,
 >
 >You gave me some pointers for dealing with the insurance before, but I
think
 >they have a method of keeping certain individuals from being approved
for
 >the pump.

Once you've decided on the type of pump you want, work with your sales
rep. 
A good pump rep will help you negotiate the insurance maze. It's in
their 
interest to know exactly what each company needs to get approval. Mine
got 
my doctor to write a letter with all the correct buzz words and I got 
approved right away. Maybe I was just lucky, but it certainly won't hurt
to 
try.

Sam

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