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Re: [IP] Re: Insurance Denied me the pump...

In a message dated 12/10/2000 9:22:33 PM US Mountain Standard Time, 
email @ redacted writes:

<< William said:
 Got a letter from my insurance company denying me my pump.  Any
 suggestions for what to say in an appeal would be helpful.  I
 plan to appeal.   >>

Look to the pump manufacturer's reps for help also.  They want to make the 
sale and they have worked the insurance hoops before.  If you have taken the 
route of going to the doctor, doctor recommending, then denial, next step I 
would take is to get the company rep involved of the pump you choose, 
Minimed, Animas, or Disetronic. It is not the insurance company's decision, 
its the doctor's.

If you have a high A1c after trying your best effort at MDI, like logging, 
training with CDE's, dietician's, etc, then you can point to that, that MDI 
doesn't work for you. Point out the DCCT findings about control and lessening 

If you have been maintaining an adequate A1c on MDI, your argument is that 
you are hypoglycimic so often, the severe low numbers are averaging out the 
high numbers and your quality of life is severely impaired.

And look in the archives here for threads on getting insurance approval.  I 
don't know of anyone recently that has been persistent and not gotten their 
pump.  Post what type of insurance you are dealing with, others may have 
specific examples of how to get thru that company.

Keep at them.  It will be approved.

Best wishes,
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