I was a little shocked, actually, to have gotten a real answer instead of a blow off "It's in medical review" answer.
My pump rep and my endo's nurse have jumped through hoops giving my insurance company the information it needs/wants in regard to approving my CGMS claim. I thought there was going to be a conversation between the insurance folks and my doctor's office, not just a flat out "No." I really thought that giving them all this information and stressing that I have hypo unawareness would surely make them say yes. Like I said, I was shocked.
I have mixed feelings about this. On one hand I'm still ready for a fight. I've called my pump rep to fill him in and see where we go from here--not to say, "I give up, thanks for trying." On this hand I feel a little angry that they have all this information detailing medical necessity and still say no.
On the other hand, though, I'm slightly relieved that the answer was no. Although I apparently still have some appealling I can do, I feel like this is a good place to be.
As you'll recall, my six-day trial with a CGMS was, well, definitely a trial. And perhaps my rep was right when he said that I really didn't get the full benefit of the technology since I only spent six days with it. I can't shake this feeling that the CGMS is really a lot of work, especially since I don't eat on a set schedule and don't often have two times of the day where my numbers have plateued to a point where it's a good time to calibrate. Not only that, but it's not 100% accurate, which is so misleading!
I'll keep going, as I've said before. Well, maybe not. This might be a good stopping point. This might be a good time to say I'm doing mostly OK managing my numbers without any added technology. I have some time to think about this because I don't get the official denial letter for a week or so and we can't do any more appealing until I get that letter.
Maybe in my case less is more.





