CGMS Denial Day, post your links here

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Permalink Reply by Gina Capone on July 3, 2008 at 8:11pm

amen!

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Permalink Reply by Lee on July 3, 2008 at 9:55pm

If it is possible to change insurance companies I would research them and do so? Write a letter to the insurance commission and have them investigate why the CGMS is not covered. It may start a trend. Talk on the phone is not enough. Have your doctor fill out a letter of need, submit it and resubmit it. Calling is frustrating as you are not dealing with the top person. Ask in writing if you are refused for an appeal. Then send all info to the insurance commission. At least it will be reviewed by an outside party. Then a final decision can be made. Good Luck. Lee

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Permalink Reply by Jenny on July 3, 2008 at 8:56pm

IN TOTAL SHOCK!!!!!

I HOLD IN MY HAND, TEARS DOWN MY FACE AN APPROVAL LETTER FOR THE CGMS!!!!!!

I cannot believe it! No denial, no fighting, just as if 'Oh, OK, here"....

Faint: THUMP!

I have yelled out SO LOUD, the dang neighbour looked over the fence thinking I'd won the lottery, and in a way, I have!

OMG, I'm going to FRAME THIS LETTER!!

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Permalink Reply by Gina Capone on July 3, 2008 at 8:57pm

GET OUT! who is your insurance company?

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Permalink Reply by Jenny on July 3, 2008 at 10:27pm

Believe it or not, Southern California's equivalent of Medicaid, with a secondary from United Care Medical Group. It is 'technically' an HMO, but I'm on SSI and P/T work in retail.

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Permalink Reply by Lee on July 3, 2008 at 9:52pm

Congratulations. You have a wonderful insurance company that recognizes the need for the CGMS. What company and state is this? Lee

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Permalink Reply by Jenny on July 3, 2008 at 10:30pm

I think the approval is directly from UCMG, and they are like an HMO. It is Medi-Cal (Medicaid in other states) so I really had things ready for war.... Holy CARP, this is really shocking. They deny everything usually....

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Permalink Reply by Lee on July 3, 2008 at 9:47pm

It is imperative that insurance companies recognize the need for the CGMS to save the lives of diabetics. I technically have had diabetes since childhood 50+ years, have hypoglycemia unawareness, have had serious lows that included seizure and unconsciousness. How close to death and how many times can this happen without the loss of the individual?Insurance companies need not discriminate. Deciding insurance parties need to be educated on the need for the CGMD. Many diabetic patients can be controlled only with CGMS effectively; to increase our chances of not having serious side effects which are extremely costly to the "system". Early stroke, death, and the complications of diabetes which are "deadly" could be avoided if insurance companies and MDs would be advocates for the Diabetic patients. Life is priceless, neglegence and negativity costs lives. Lee

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Permalink Reply by kelly close on July 4, 2008 at 9:03pm

cool, Gina.... see our link for Jim Hirsch's In Search Of Reimbursement: A CGM Odyssey ....

http://www.diatribe.us/issues/7/logbook.php ~

this is denial with a happy ending ...

http://www.diatribe.us/issues/8/logbook.php
#B027 And Me: An Update On A Reimbursement Odyssey

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Permalink Reply by Lee Ann on July 27, 2008 at 8:18am

My CGMS story started off as a happy anomaly, but became Another Sad CGMS Saga

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Permalink Reply by Marshy on September 6, 2008 at 5:16pm

Finally received a reimbursement from Horizon Blue Cross Blue Shield of New Jersey. Still a few "glitches" to work out but it looks like all of my letters and letters from the doctor and government officials has paid off.

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