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Re: [IP] Another Denial.....Grrrr (kinda long)
----- Original Message -----
From: <email @ redacted>
To: <email @ redacted>
Sent: Saturday, June 09, 2001 12:52 AM
Subject: [IP] Another Denial.....Grrrr (kinda long)
> I have been trying for almost two months to get everything in order so
> can get off the rollercoaster and move onto the pump. Unfortunately, my
> insurance company doesn't see it that way. After reviewing my records,
> denied the pump on the basis that my last A1c was 6.5 and I've never been
> hospitalized for a severe hypoglycemic event. (Here comes the vent) How
> ridiculous!!!! OF COURSE ....I have good A1C numbers because I have lows
> EVERYDAY.....EVERYDAY I swing between 250 and 30, most times I can be get
> below 50 and not even know it. DOn't they know that the A1C is just an
> average?? (One time I was feeling a little wierd, tested and was at
> 19....that's my lowest that I've caught on my meter). I have had nighttime
> episodes where I've gone into convulsions and if I didn't have my wife
> sleeping next to me, I probably wouldn't be around to talk about it today.
> But.......according to them:
> "The medical services are not certified because the patient has acheived
> excellent control of his diabetes with his current regimen. He is not
> frequent or severe hypoglycemic episodes. For this reason, use of an
> pump is not medically necessary"
> Where did they come up with that??
Write down ALL of your Blood Sugars EVERY DAY for at least a week or two
every time you test, then fax or mail them to your insurance co. If they
don't see that your on a roller coaster that way there is something wrong.
I did this with BC/BS and the fact that I had been hospitalized twice they
wanted it so I sent them copys of everything I had at the time, and was
approved first time around for 100% of the cost.
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