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	<title>Salty and Sweet &#187; CGMS</title>
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	<link>http://saltyandsweet.org</link>
	<description>Daily life fighting Cystic Fibrosis and Cystic Fibrosis Related Diabetes.</description>
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		<title>It is about time!</title>
		<link>http://saltyandsweet.org/2008/07/24/it-is-about-time/</link>
		<comments>http://saltyandsweet.org/2008/07/24/it-is-about-time/#comments</comments>
		<pubDate>Thu, 24 Jul 2008 16:42:23 +0000</pubDate>
		<dc:creator>Salty</dc:creator>
				<category><![CDATA[Cystic Fibrosis]]></category>
		<category><![CDATA[Cystic Fibrosis Related Diabetes]]></category>
		<category><![CDATA[Life in General]]></category>
		<category><![CDATA[diabetes]]></category>
		<category><![CDATA[insulin pump]]></category>
		<category><![CDATA[CGMS]]></category>
		<category><![CDATA[good day]]></category>
		<category><![CDATA[rainbow]]></category>

		<guid isPermaLink="false">http://saltyandsweet.org/?p=293</guid>
		<description><![CDATA[Yesterday I had an awesome doctor&#8217;s visit.  My lungs are in decent shape (any time there is no decline it is awesome news!), my blood sugars look great (I owe it to my new insulin pump), I found out my insurance paid their part of my continuous glucose monitor&#8230;&#8230;  wait&#8230; what???? Yep! I noticed online [...]]]></description>
			<content:encoded><![CDATA[<p>Yesterday I had an awesome doctor&#8217;s visit.  My lungs are in decent shape (any time there is no decline it is awesome news!), my blood sugars look great (I owe it to my new insulin pump), I found out my insurance paid their part of my continuous glucose monitor&#8230;&#8230;  wait&#8230; what???? Yep! I noticed online that FINALLY, after seven months of fighting, they finally paid their part.  I have three months of supplies, and hopefully when I go to refill I won&#8217;t have the same problem all over again, but I will worry about that later.  Excuse me while I do my victory dance AGAIN!!!!</p>
<p style="text-align: center;"><img class="size-full wp-image-294 alignnone" title="dance" src="http://saltyandsweet.org/wp-content/uploads/2008/07/dance.gif" alt="" width="167" height="192" /></p>
<p>Yesterday was a great day.  I had such a good visit with the docs, they almost didn&#8217;t know what to do with me since I had such a rough go for the past 8 months.  Doc thinks I should be good for a while now, especially since I have been so good with my treatments.</p>
<p>I stopped by mom&#8217;s after my appointment to spread the happiness and we had a great dinner and did a little grocery shopping where both of our bills ended up the exact same amount, but we got totally different things.  That was a little erie. When we left, we saw the most beautiful rainbows. My camera phone didn&#8217;t do it any justice.</p>
<p style="text-align: center;"><img class="size-medium wp-image-295 alignnone" title="img00075" src="http://saltyandsweet.org/wp-content/uploads/2008/07/img00075-225x300.jpg" alt="" width="225" height="300" /></p>
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		<title>Denied again &#8211; Update &#8211; the letter</title>
		<link>http://saltyandsweet.org/2008/02/15/denied-again-update-the-letter/</link>
		<comments>http://saltyandsweet.org/2008/02/15/denied-again-update-the-letter/#comments</comments>
		<pubDate>Fri, 15 Feb 2008 18:42:49 +0000</pubDate>
		<dc:creator>Salty</dc:creator>
				<category><![CDATA[Challenges]]></category>
		<category><![CDATA[Cystic Fibrosis]]></category>
		<category><![CDATA[Cystic Fibrosis Related Diabetes]]></category>
		<category><![CDATA[diabetes]]></category>
		<category><![CDATA[insulin pump]]></category>
		<category><![CDATA[insurance]]></category>
		<category><![CDATA[appeal]]></category>
		<category><![CDATA[CGMS]]></category>
		<category><![CDATA[decision]]></category>
		<category><![CDATA[denial letter]]></category>
		<category><![CDATA[GreatWest Healthcare]]></category>
		<category><![CDATA[insurance coverage]]></category>

		<guid isPermaLink="false">http://saltyandsweet.wordpress.com/?p=107</guid>
		<description><![CDATA[I received the latest letter of denial from my insurance company.
Here&#8217;s what the letter says:
&#8220;This appeal was reviewed by an independent external consultant, Board Certified in Internal Medicine with a Sub Specialty Certificate in Endocrinology Diabetes &#38; Metabolism&#8230;.
&#8230; Although the patient has met the criteria of being on on intensified insulin therapy program, and has [...]]]></description>
			<content:encoded><![CDATA[<p class="MsoNormal">I received the latest letter of denial from my insurance company.</p>
<p class="MsoNormal">Here&#8217;s what the letter says:<br />
<em>&#8220;This appeal was reviewed by an independent external consultant, Board Certified in Internal Medicine with a Sub Specialty Certificate in Endocrinology Diabetes &amp; Metabolism&#8230;.<br />
&#8230; Although the patient has met the criteria of being on on intensified insulin therapy program, and has a hemoglobin A1C of greater than 7%, there is no documentation to support low endogenous levels in the member. Her C-peptide level is within normal limits, which is not unexpected, since cystic fibrosis is associated with impaired glucose tolerance rather than primarily decreased insulin production.&#8221; </em></p>
<p>Now, I am quite confused. I thought that <a href="http://saltyandsweet.org/2007/12/what-is-cystic-fibrosis-related-diabetes/">CFRD</a> was caused because of decreased insulin production because the pancreas is damaged and not able to produce enough insulin to keep blood glucose at safe levels? Could their &#8220;expert&#8221; be wrong?!</p>
<p class="MsoNormal">(-sarcastic comment warning-) I am wondering if the independent reviewer believes that I am overweight (5&#8242;5&#8243; 107lbs) and should control his assumption of &#8220;Type 2&#8243; diabetes by dieting.  OH PLEASE!!</p>
<p class="MsoNormal">Note: <a title="CFRD Not Type 1 Not Type 2" href="http://saltyandsweet.org/2008/01/why-is-my-diabetes-not-type-1-or-not-type-2-why-is-it-related-to-cf/">I do NOT have Type 1 OR Type 2 diabetes</a>.  I have CF Related Diabetes.  It is a whole different bear all it&#8217;s own.</p>
<p class="MsoNormal">Here is the denial for the continuous glucose monitor:</p>
<p class="MsoNormal"><em>&#8220;The continuous glucose monitor was denied again because it &#8220;is still considered experimental and investigational, with the therapeutic benefit yet to be proven in large-scale long-term studies. &#8230; continuous glucose monitoring system is considered experimental / investigational / unproven and is not in accordance with generally accepted standards of medical practice at he the present time, it would not be considered medically necessary.&#8221; </em></p>
<p>Does any one have any comments or suggestions about how to refute this claim??</p>
<p class="MsoNormal">I have found out that my insurance, GreatWest Healthcare, is notorious for denying coverage for insulin pumps. Unfortunately I can not switch my insurance policy, as it is the only one offered by my employer.</p>
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