update update update (my CGMS appeal, again - still)

Jenny was kind enough to remind me that my last blog was nearly a year ago. Yikes. Talk about not actually writing a blog! Indeed, it's true when I say that I've been busy with graduate school and yes, appeals. I am all over the appeal process like the summer sun on the garden bed. Regence BCBS may have thought the summer of my request would never arrive, that the cold dark winter of denying me a CGMS was their forever-season. But the seasons always turn, don't they?

But today!! Today I mailed a heavy envelope of hard-hitting THIRD APPEAL documents to shock them into submission, one hopes. I relied heavily on the letter our tudiabetes friend Marcy (and disappearing Rick's advice too) provided for me, although I adapted it to my own specifics and added in more citations. I have demanded of Regence BCBS of Oregon to provide me, in writing, the exact documented reasons why they claim that the CGMS is still investigational - even though it is approved and out of the Pre-Market phase by the FDA.

Now that the letter is sent, I can do nothing more. However, they have been told, in no uncertain terms, that if there isn't a favorable outcome to this LAST appeal (which is the IRO - Independent Review Organization phase) that I'll be forced to contact the Oregon Business something or other official - insurance sector for further investigation. I know they have succeeded in overturning a decision by an insurance company for a woman who had a cgms denied for her son. So, even though I *know* the insurance co's are underhanded and out-of-sync with the reality of living with diabetes, I still am hoping that I get prior approval. Hoping, wishing and praying - but now I'm going out to live life and wait as patiently as I can.


And yes, when are Minimed and Dexcom going to make these systems within the affordable range for everyday people??

Views: 16

Comment by Sweeter Cherise on June 27, 2008 at 6:39pm
That's a long time!!! I don't think it's right!!! I think insurance companies need to stop being _________; you can fill in the blank.

I am going to support CGM DENIED...:)
Comment by J. Davis Harte on June 30, 2008 at 6:28am
I agree, of course - but you know, one of the reasons the appeal process has taken almost a whole year is because I've been so swamped with writing a master's thesis and taking courses that I haven't had the time to write the appeals. That said- it's not as if they make the process very easy, now, do they?


You need to be a member of Diabetes community by Diabetes Hands Foundation: TuDiabetes to add comments!

Join Diabetes community by Diabetes Hands Foundation: TuDiabetes



From the Diabetes Hands Foundation blog...

DHF receives $200,000 grant from Novo Nordisk

Grant given to support programs aimed at bringing together people touched by diabetes for positive change BERKELEY, CA: December 4, 2014 – Diabetes Hands Foundation (DHF) has received a grant of US$200,000 from Novo Nordisk to support programs aimed at Read on! →

Guest Post: World Diabetes Day 2014 on Twitter… sifting through the data

At Symplur we track hashtags, keywords, user accounts, and pretty much anything else on Twitter that has to do with healthcare. We collect the data and then build countless ways to slice it up so that we’re able to better Read on! →

Diabetes Hands Foundation Team


Manny Hernandez
(Co-Founder, Editor, has LADA)

Emily Coles
(Head of Communities, has type 1)

Mila Ferrer
(EsTuDiabetes Community Manager, mother of a child with type 1)

Mike Lawson
(Head of Experience, has type 1)

Corinna Cornejo
(Development Manager, has type 2)

Desiree Johnson  (Administrative and Programs Assistant, has type 1)


Lead Administrator

Brian (bsc) (has type 2)


Lorraine (mother of type 1)
Marie B (has type 1)

DanP (has Type 1)

Gary (has type 2)

David (has type 2)


LIKE us on Facebook

Spread the word


This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information: verify here.

© 2014   A community of people touched by diabetes, run by the Diabetes Hands Foundation.

Badges  |  Contact Us  |  Terms of Service