[Previous Months][Date Index][Thread Index][Join - Register][Login]
  [Message Prev][Message Next][Thread Prev][Thread Next]

Re: [IPp] GlucoWatch appeal

Dear Kerri,
  Good luck with your appeal!  You know, it amazes me that these insurance
companies wouldn't do something that would be considered preventative care.
Luckily, our insurance company is pretty good about that as long as they
have the necessary documentation to support it.
  I certainly wish you luck!
----- Original Message -----
From: "maverickmom (Kerri)" <email @ redacted>
To: <email @ redacted>
Sent: Sunday, December 01, 2002 5:25 PM
Subject: [IPp] GlucoWatch appeal

> Please do your share and make a tax deductible donation to the FALL
> pledge drive. Your help is needed to raise the remaining funds
> necessary for Oct, Nov, Dec. Won't you please give $10 or $20 a year?
>     http://www.insulin-pumpers.org/donate.shtml
> Your annual contribution will eliminate this header from your IP mail
> For those of you following my GlucoWatch appeal (I had sent in an
> appeal letter with 7 supporting documents to the military
> insurance, TriCare, about a month ago), I finally heard back from
> them the day before Thanksgiving. They upheld the original
> decision and denied me again. Our endo is po'd and thinks they
> are just stalling (so do I). He said my appeal and documents more
> than proved the safety and effectiveness of the device (which was
> the issue in their first denial). Seems they've switched gears on
> me, however, and now the issue seems to be whether it is
> medically necessary or not (very difficult if not impossible to
> prove that, short of allowing my daughter to seize.) I don't see
> how they can do this. I addressed the only issue they had with it
> (the only one they ever mentioned) and gave them exactly what
> they asked for (peer-reviewed articles, clinical trials, etc),
> and now they've upped the ante, asking for the impossible (and
> they know it). In this latest response, it was very apparent that
> they hadn't read my appeal letter or ANY of the documents (which
> they asked for!!! And I spent a month+ working on it.) I have 60
> days to respond and our endo said before I do, he wants to look
> into some things for me (ie: what other TriCare regions are doing
> etc.) He said if they are covering it then we may be able to
> complain. I have 2 more levels of appeals to go through and one
> or both of them are in-person (ugh!) That's okay, I have a
> strategy in mind (anyone ever seen Legally Blonde? LOL!) ;)
> Take care, Kerri - IM me on MSN: maverickmom1965
> Parents of Pumpers chat host, Saturdays 9:30pm EDT, Parents chat
> room at www.insulin-pumpers.org
> "doce ut discas" (teach that you may learn)
> ----------------------------------------------------------
> for HELP or to subscribe/unsubscribe, contact:
> HELP@insulin-pumpers.org
for HELP or to subscribe/unsubscribe, contact: