Thursday, January 10, 2013

Denied

So as diabetes goes, I feel pretty confident I have a handle on it's quirky ways.  So confident in fact, Rick and I decided we were ready to start the insulin pump process for Madeline.  This is not an easy transition, but Madeline's diabetes team gave us the encouragement to start the process.  Learning to use the insulin pump is not for someone who isn't in it for the long haul, but the end result would be so worth it.  Madeline would gain a tiny bit of freedom from her diabetic life, and Rick and I would know we have done absolutely everything we can to give her the healthiest life possible.   

We took our first class at children's hospital to learn all the insulin pumps that were available and how to use them.    All three of us had a three day trial of wearing a non-working pump just to see what we thought of them.  Omnipod, Medtronic and Animas.   In the end, we decided the Animas insulin pump was the right choice for Madeline.  I was nervous, excited and stressed all at the same time.  I completed the paperwork immediately and sent everything in to Animas.  I was overjoyed to learn that Animas would take care of all the paperwork between the doctors office and the insurance company.  Why did that seem too easy?  Now I just had to wait.  And wait.

The paperwork was submitted mid December, but neither I, nor Animas, had heard anything from the insurance company.  Ruh-Ro.

I finally received the unwanted call from Animas this week letting me know Madeline had been denied approval for an insulin pump from the insurance company.  "Not medically necessary" was the reason.  Really?  Gee, what would make an insulin pump for a person with a busted pancreas medically necessary?  I could go on a rant very easily over all the reasons I found this to be a ridiculous reason, but since I do not have the official denial letter yet, I will give the benefit of the doubt, and keep my mouth shut - at least on my blog :).  We have chosen to appeal this decision, and will jump through whatever hoops it takes to get approved.  Madeline deserves it.

Not medically necessary.

Ugh.  That's all I can say........ 

 


    

       

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