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valid reason for appeals

Discussion in 'Insurance Issues' started by vettechmomof2, May 1, 2008.

  1. vettechmomof2

    vettechmomof2 Approved members

    Joined:
    Jul 13, 2007
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    Does everyone believe that a dramatically reduced A1C is a valid reason for an appeals process for insurance coverage for our cgms?
    I was thinking of putting that into my next appeal: the before A1C and the after one with a letter coumenting the "obvious" benefit of the device.
    Any thoughts,
    Allene
     
  2. jules12

    jules12 Approved members

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    May 26, 2007
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    I didn't use that for a reason because my insurance company used a study that showed there wasn't that much improvement in A1c values. Everyone's situation varies but I am focusing on control - fewer Hyper/Hypo episodes rather than a1c results - our A1c's have all be in the 6's since dx so I don't think it would help us too much.

    Having said the above, we have not won yet so you might want to read through the threads and see what others say.
     
  3. vettechmomof2

    vettechmomof2 Approved members

    Joined:
    Jul 13, 2007
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    thanks,
    I have been and this will be my 5th appeal and it does feel like a losing battle. just keeps going round and round but no where else.
    oh well, there is always a chance.
    Allene
     

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