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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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