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[IP] Prudential and payment for D pump
In the middle of 12-97 I purchased a Disetronic pump. The Mini-med rep
for my endo was too over-powering, dictatorial, and self-aggrandizing.
I purchased the pump outright, having the now obviously ridiculous
notion that I wanted to be myself responsible for all facets of this
wonderful piece of technology and believing that we all should assume
responsibility for our own care. How naive I am!
I initiated contact with above insurance company before purchase of said
pump, calling twice to make certain I, as well as they, understood all
the parameters of my coverage. Two more calls were made to ascertain
that I was providing the correct and adequate documentation.
On 1-22-98 my husband mailed the claim (our insurance is his employee
benefit). First the claim in its entireity was denied - including the
bills from my endo - all two of them (I have been IDDM for 32 years!).
A series of communications - absolutely ludicrous in their content -
ensued. Prudential has now paid for one pump - $2400, completely
ignoring documentation stating that Disetronic only sells pumps in
pairs. It was only after one of my students leaped to the same
conclusion that I have been expecting Prudential to eventually reach
(not, however, via a leap), and this after a 60 second diatribe from me,
that I opted to bring this to you.
Now, Prudential "needs" a statement from my endo attesting to my need
for two pumps! I have by the way gleaned the info that mine is to be a
test case, Prudential vs D re two pumps.
HELP! I still love my pump; love more so the person I am with the pump.
I am very impressed with all of your technical abilities that I am
certain I will "net" many strategies from this communication.
I am very grateful for your willingness to share your experiences on the
net. I am sure there are many of us who silently read, learn, and
empathize with those of you courageous enough to speak out so
Insulin-Pumpers website http://www.bizsystems.com/Diabetes/