November 13, 2012

advice for arguing

I need some advice from the diabetes community out there.

My insurance has denied coverage of a Dexcom system for me 2x now. I've submitted all the requested paperwork, had my doctor write a letter of recommendation, and even wore a sensor for a week's trial.

They still hate me.

They don't find it medically necessary because I don't have lows in the middle of the night and I don't have lows where I need assistance (which is, hello, a good thing).

I know the insurance industry is completely backwards when it comes to stuff like this. I bet I could get them to give me any other expensive pill out there. And gladly. But when it comes to an amazing machine like the Dex? Nah....she doesn't need it. She just needs better control.

Well, you know all those patients on cholesterol medication just need better control to stop eating so much junk food.....

I digress.

So I have decided to appeal again and want to write a detailed letter to them stating facts and figures as well as including some information about the less tangible side of diabetes--the emotional aspects of it. But I cannot decide where to begin.

Where would you start and what information would you include??

1 comment:

  1. Is your doctor willing to make a phone call? My doc called the head of something for an insurance company. I don't know how that convo went, but I ended up with a Dex.
    Good Luck!


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