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Re: [IP] Insurance is backpedaling on paying
Sounds from your discussion that the primary reasons for putting Kayla on
the pump were:
1) To reduce the likelihood of repeated hospitalization due to diabetic
complications brought on by the gastro problems;
2) To return some degree of "normalcy" to your lives by more effectively
managing her illnesses.
The first should be easily documented (hopefully). If Kayla has not been
sick / hospitalized in the six weeks she's had the pump, document it, with
support from your endo. It appears Kayla's already doing better in this
regard than she was "pre pump".
The second point may be more difficult to document, since it might fall
into the category of "quality of life", but it's something to consider.
In addition, compute how much this improvement in Kayla's gastro problems
has saved the insurance company (may be useful information later on) in
hospital / ER visits.
Try to document how Kayla's stability re: gastro problems has also
contributed to overall better "trends" in her diabetes management.
>Our main reason for putting Kayla on the pump wasn't for better overall
>control. It was because for some unknown reason Kayla pukes a lot.
>Sorry to be gross, but that's the truth. She gets bouts of vomiting
>that are uncontrollable and she's been in the hospital three times in
>less than a year because of it. BG bottoms out, ketones go through the
>roof and she can't even keep liquids down. The pump makes managing
>illnesses easier. Since she began pumping, she hasn't puked a single
>time. Before pumping she couldn't go two weeks without 'praying at the
>porcelain altar'. Her endo agreed to pumping precisely for this reason
>and stated that in his letter to GEHA. So their wanting to see improved
>control has nothing to do with the original reason for putting Kayla on
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