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RE: [IP] How to get the pump (to Sue)

Sue....I haven't "officially" started pumping yet, although I've worn my
Disetronic with saline solution and think I'm gonna like it.  After lots of
careful consideration, I decided on my own that I wanted the pump in order
to "stop the rollercoaster" so to speak.  I have never been able to obtain
"great" control with MI and once I'd made my decision...I contacted
Disetronic myself and asked their insurance coordinator to send the
necessary forms to my doctor (who at the time was only a GP - I'm now seeing
an endo) which she did.  I called the doctor to tell him they were on the
way and explained how a pump would improve my "quality of life".  He agreed
and sent the forms back stating a pump was a medical necessity for me.  I
had the pump with 48 hours.   A couple of days later....his nurse called to
say "we've gotta talk about this pump thing......"  as they were clueless
about what to do with it.  At that point I contacted my insurance company
who agreed that it was now "medically necessary" for me to see an endo
(since I had a pump) and they agreed to pay him at the participating rate
even though he was not a participant in their PPO.   Seems the insurance
company has a diabetes coordinator who knew what I was talking about and
convinced them to pay the endo at the 90% rate vs. the 70% rate.  It took a
lot of phone calls but I'm proud to say that persistance pays off :-)  

On my first visit to the endo....he informed me he'd never had a patient
come into his office with the pump in hand and ask for him to set the basals
for them.  I provided him with months of data....bg readings, copies of
labs, etc.  He was impressed to say the least and spent over 2 hours with me
that day just talking about my DM.  He said he'd do his homework and
calculate the basals as closely as possible so that I can start pumping on
9/22 under the supervision of the Diabetes Treatment Center nurses.  

Good Luck!

Carol Wilson
Type 1 - 21+ yrs
Pumping as of 9/22

> -----Original Message-----
> From:	Sue W [SMTP:email @ redacted]
> Sent:	Friday, September 11, 1998 10:07 AM
> To:	email @ redacted
> Subject:	Re: [IP] I Need Your Letters !   (2nd request)
> Hi Sherri,
> I have looked through the archives.
> I am not looking to get an insulin pump for a CHILD.  I am trying to get
> one for myself -- an ADULT!  At my age, I shouldn't have to prove that I
> am mature enough to operate a pump.
> I am well aware that my doctor knows a lot about pump usage.  What I am
> trying to show him is that I have done my research and homework and that
> I am well informed, too.  I am also trying to show that this request
> isn't just some "whim" but that it is well thought out.
> At this time, I am reaching out with a request to several hundred people
> on this list and asking for their help.  I do not expect a response from
> each and every one of them!  However, if it bothers you so much,
> personally, that I would ask for help here -- then maybe you need to try
> out your DELETE key!  Putting my name in a killfile would work too --
> then none of my messages could bother you because they wouldn't reach
> you.
> > Possibly you should read back through the archives where you will find
> > testament after testament as to how the pump has drastically improved
> the
> > lives of the people on this insulin pumpers lists.   There are also
> quite a
> > few websites where stories such as this are already posted.
> > 
> > We have been through a lot trying to secure an insulin pump for our
> daughter
> > and thankfully just last week he began our letter of necessity to submit
> to
> > our insurance company.  I could have submitted all the letters in the
> world
> > that praised the use of the pump but ultimately it boiled down to the
> fact
> > that he had to feel that WE would use the pump in a resonsible manner
> and he
> > also wanted to make sure we knew what we were getting into.  However, we
> > always approached him in a mature, calm fashion and he respected our
> feelings
> > and we also understood his concerns.  He has worked through those
> concerns and
> > at this point he is as delighted for us as we are.  Also from what we
> > understand, Laura will be one of the youngest insulin pumpers in
> Oklahoma.
> > 
> > You said in your letter that he is an endo who "already prescribes many
> pumps
> > for his patients."  If this is the case, he should already know the
> benefits
> > of pumping.
> -- 
> 	... Sue  :-)
> 		We can get information online ...
> 		but wisdom comes from On High!
> "Sue's Plain Vanilla HomePage"
> http://www.inconnect.com/~sue/
> E-Mail - mailto:email @ redacted
> ----------------------------------------------------------
> Insulin-Pumpers website http://www.bizsystems.com/Diabetes/
Insulin-Pumpers website http://www.bizsystems.com/Diabetes/