[Previous Months][Date Index][Thread Index][Join - Register][Login]   Help@Insulin-Pumpers.org
  [Message Prev][Message Next][Thread Prev][Thread Next]   for subscribe/unsubscribe assistance
 
 

Re: [IP] CGMS Denial Info--Susan's question



At 02:36 PM 7/6/2008, DAVID HANCOCK wrote:
>Since you don't meet the criteria the answer would be "no." Since it
>sounds like you are in good control I doubt doing a peer to peer
>would overturn the decision either. In this case the physician
>reviewer would probably consider CGMS a "convenience" item and those
>are never covered.

Interestingly, there was a list for "medical necessity" for getting 
an insulin pump.  One regarded an A1c over a certain amount (I don't 
remember exactly the number now).  My endo told me I would not get 
approved for a pump since my A1c at the time was always in the 
5-range.  However, I could go from a bg of 300 to 30 and back again 
in a matter of an hour or less.  I was approved for my pump by my 
insurance company with no questions asked.

My point is... always go for approval even if you think your 
insurance may not approve it.

RoseLea 
.
----------------------------------------------------------
for HELP or to subscribe/unsubscribe/change list versions,
contact: HELP@insulin-pumpers.org