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Re: [IP] Michael, what do I do?

>RoseLea and Max... back to fighting the insurance company!

Don't give up the battle!  We went through same deal with our 
insurance co.  Very lengthy process (three months) of getting 
denials, filing grievances, etc.  We had initially submitted 
everything to back up our decision for the pump - letter from endo, 
statistics on improved control, testimonials from children pumpers on 
improved control (from www.members.aol.com/CamelsRFun), and our own 
reasons for wanting the pump.  This shouldn't be necessary - you 
should be entitled to receive the best possible treatment available. 
Makes me angry the dance we have to perform to get what we're 
entitled to.  I really get angry knowing there are many people out 
there who get denied from there insurance co. and don't pursue it. 
The insurance co. knows they can't win, but they'll take it as far as 
possible hoping you get weary and go away.  That's what happened with 
us.  We were a thorn in their side.  As I said, we did our homework, 
submitted more info than they needed, and continually got denied, 
went through appeals' process. It was finally scheduled to be heard 
at the state level in Harrisburg (we live in PA).  We also got a 
diabetes advocate involved and she made a call to the ins. co. on our 
behalf a couple of days prior to hearing.  The day before the 
hearing, we got a call saying the pump had been approved!!  They knew 
they were going to lose but wanted to see how serious we were about 
taking it to that far.  Hang in there - we're glad we did - hopefully 
to also help pave the way for others.

Cindy, mom to 13 y/o Noah, dx 6/96, pumper since 7/99

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