Yesterday, I was at work doing my daily duties and at about 2pm my cell phone rang.
Me: A little reluctant to answer because it looks like a spam caller I do anyway..Hello?
Caller: Ms. Capone
Me: Yes, that is me.
Caller: This is "M" from Minimed calling in regards to your appeal for a Continuous Glucose Monitor.
Me: A little excited...Am I approved?
"M" the MM Rep: No, we were contacted by your CDE and we will be handling your case moving forward.
Me: Oh, great. (At this point I will take any help I can get.)
Molly the MM Rep: I have to ask you a few questions.
She proceeded to ask me a bunch of questions about my current insurance, how many times I was approved, my last A1c, how high was my highest high and how low my lowest low was. How many times do I check my blood on average. And some others.
I also explained to her how this past summer I wore a CGM twice, and with the data and trends information how my CDE helped me make adjustments in my diabetes management that were pretty much impossible to figure out before, and how my last A1c was lower because of it. I told her how I haven't had an A1c below 8 in 5 or 6 years.
She responded that this was good information to provide regarding my case and that she would document it in the appeal. She said I was definitely a candidate for a CGM. I told her that I have heard this all before. And that it has been a long year of fighting with the insurance company. She clearly felt my frustration just from hearing my voice, and told me that she would do everything she could to help me win my appeal. She also said that more insurance companies have been covering lately, and my insurance has actually changed their policy since my last appeal in late August.
Well, all I can do is wait. I have already gotten used to the denials so if I get denied again I wouldn't be that surprised. But, I won't stop trying. There are times that I really want to give up because it is such an exhausting process. The calls, the letters, the waiting, the repeated denials.
Hopefully, it will all be over soon and I can finally write a post that says, I HAVE BEEN APPROVED!
Until then help join me in the fight and Sign the CGM Anti-Denial Petition