Insurance denied coverage again

SaltyAndSweet · Feb 14, 2008

Here's what the letter says:
"This appeal was reviewed by an independent external consultant, Board Certified in Internal Medicine with a Sub Speciality Certificate in Endocrinology Diabetes & Metabolism....
... 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 nomal limits, which is not unexpected, since cystic fibrosis is associated with impared glucose tolerance rather than primarily decreased insulin production."

Now, I am quite confused. I thought that CFRD 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?

"The continuous glucose monitor was denied again because it "is still considered experimental and investigational, with the theraputic benefit yet to be proven in large-scale long-term studies. ... continuous glucose monitoring system is considered experimental / investigational/ unproven and is not in accordance with generally accepted standards of medical practice athe the present time, it would not be considered medically necessary."

Any one have any comments or suggestions about how to refute this claim??

SaltyAndSweet · Feb 14, 2008

Here's what the letter says:
"This appeal was reviewed by an independent external consultant, Board Certified in Internal Medicine with a Sub Speciality Certificate in Endocrinology Diabetes & Metabolism....
... 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 nomal limits, which is not unexpected, since cystic fibrosis is associated with impared glucose tolerance rather than primarily decreased insulin production."

Now, I am quite confused. I thought that CFRD 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?

"The continuous glucose monitor was denied again because it "is still considered experimental and investigational, with the theraputic benefit yet to be proven in large-scale long-term studies. ... continuous glucose monitoring system is considered experimental / investigational/ unproven and is not in accordance with generally accepted standards of medical practice athe the present time, it would not be considered medically necessary."

Any one have any comments or suggestions about how to refute this claim??

SaltyAndSweet · Feb 14, 2008

Here's what the letter says:
"This appeal was reviewed by an independent external consultant, Board Certified in Internal Medicine with a Sub Speciality Certificate in Endocrinology Diabetes & Metabolism....
... 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 nomal limits, which is not unexpected, since cystic fibrosis is associated with impared glucose tolerance rather than primarily decreased insulin production."

Now, I am quite confused. I thought that CFRD 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?

"The continuous glucose monitor was denied again because it "is still considered experimental and investigational, with the theraputic benefit yet to be proven in large-scale long-term studies. ... continuous glucose monitoring system is considered experimental / investigational/ unproven and is not in accordance with generally accepted standards of medical practice athe the present time, it would not be considered medically necessary."

Any one have any comments or suggestions about how to refute this claim??

SaltyAndSweet · Feb 14, 2008

Here's what the letter says:
"This appeal was reviewed by an independent external consultant, Board Certified in Internal Medicine with a Sub Speciality Certificate in Endocrinology Diabetes & Metabolism....
... 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 nomal limits, which is not unexpected, since cystic fibrosis is associated with impared glucose tolerance rather than primarily decreased insulin production."

Now, I am quite confused. I thought that CFRD 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?

"The continuous glucose monitor was denied again because it "is still considered experimental and investigational, with the theraputic benefit yet to be proven in large-scale long-term studies. ... continuous glucose monitoring system is considered experimental / investigational/ unproven and is not in accordance with generally accepted standards of medical practice athe the present time, it would not be considered medically necessary."

Any one have any comments or suggestions about how to refute this claim??

SaltyAndSweet · Feb 14, 2008

Here's what the letter says:
"This appeal was reviewed by an independent external consultant, Board Certified in Internal Medicine with a Sub Speciality Certificate in Endocrinology Diabetes & Metabolism....
... 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 nomal limits, which is not unexpected, since cystic fibrosis is associated with impared glucose tolerance rather than primarily decreased insulin production."

Now, I am quite confused. I thought that CFRD 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?

"The continuous glucose monitor was denied again because it "is still considered experimental and investigational, with the theraputic benefit yet to be proven in large-scale long-term studies. ... continuous glucose monitoring system is considered experimental / investigational/ unproven and is not in accordance with generally accepted standards of medical practice athe the present time, it would not be considered medically necessary."

Any one have any comments or suggestions about how to refute this claim??

Sevenstars · Feb 15, 2008

<div class="FTQUOTE"><begin quote>Originally posted by: SaltyAndSweet Her C-peptide level is within nomal limits, which is not expected, since cystic fibrosis is associated with impared glucose tolerance rather than primarily decreased insulin production."</end quote></div>

First of all, this sentence makes no sense at all - their "doctor" just contradicted himself. It should read that IS expected, because decreased insulin production would make your c-peptide level low. I guess that's what you get when you pay people to write a report that they have no say in...

Anyway, aside from the idiotic letter, it seems your best recourse now is to either find a patient advocate (see following link) or assault them with a stack of studies - or both. I did some digging and found a good bit of stuff regarding the pump being used in CF patients, all with great success. Also attached a few studies involving Type 1 patients, which I suppose your doctor could claim you are analogous to, since you are dependent on insulin.

Awesome article about how to deal with insurance companies (look at the section about Advocates):

<a target=_blank class=ftalternatingbarlinklarge href="http://www.health.com/health/article/0,23414,1663353,00.html
">http://www.health.com/health/a...1663353,00.html
</a>

Mention the pump specifically:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.imj.ie//Issue_detail.aspx?pid=838&type=Papers&searchString=diabetes%20cystic%20fibrosis
">http://www.imj.ie//Issue_detai...stic%20fibrosis
</a>
<a target=_blank class=ftalternatingbarlinklarge href="http://www.liebertonline.com/doi/pdf/10.1089/dia.2007.0238
">http://www.liebertonline.com/d...9/dia.2007.0238
</a>

Related to insulin requirements:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.ncbi.nlm.nih.gov/pubmed/11529531
">http://www.ncbi.nlm.nih.gov/pubmed/11529531
</a>

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C3K7PC-1J&_user=10&_coverDate=02%2F28%2F1994&_alid=690028626&_rdoc=4&_fmt=summary&_orig=mlkt&_cdi=6952&_sort=v&_st=17&_docanchor=&view=c&_ct=47070&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=073d32147a9bfc6ee21615f2c8d3e100
">http://www.sciencedirect.com/s...21615f2c8d3e100
</a>

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WCM-45FCHCN-1H&_user=10&_coverDate=04%2F30%2F2000&_alid=690028626&_rdoc=56&_fmt=summary&_orig=mlkt&_cdi=6742&_st=17&_docanchor=&view=c&_ct=47070&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=02c57c922b9486e9dc0d6743f9d0099c
">http://www.sciencedirect.com/s...c0d6743f9d0099c
</a>

Studies I can't find the full text for (for free, anyway):

<a target=_blank class=ftalternatingbarlinklarge href="http://www.cysticfibrosisjournal.com/article/S1569-1993(05)00117-7/abstract
">http://www.cysticfibrosisjourn...0117-7/abstract
</a>

Journal of Cystic Fibrosis, Volume 5, Supplement 1, 2006
A272/S63 Use of continuous subcutaneous glucose monitoring system (CSGMS) in the management of CFRD: the CFRD team and patient perspective
M. Butler1, R. Driver2, C. Elston1, G.A. Hitman2, L.M. Kuitert1.
1Adult CF Service, London Chest Hospital, 2Department of Diabetes, Royal London Hospital, London, UK

Some general studies about pumps used in Type 1 Diabetes:

<a target=_blank class=ftalternatingbarlinklarge href="http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=88324&Ausgabe=231258&ProduktNr=224036&filename=88324.pdf
">http://content.karger.com/Prod...ename=88324.pdf
</a>
P1-555 Pg 163
P1-546 Pg 161

Good luck, from the sounds of that letter you'll probably need it. <img src=""> <img src="">

Sevenstars · Feb 15, 2008

<div class="FTQUOTE"><begin quote>Originally posted by: SaltyAndSweet Her C-peptide level is within nomal limits, which is not expected, since cystic fibrosis is associated with impared glucose tolerance rather than primarily decreased insulin production."</end quote></div>

First of all, this sentence makes no sense at all - their "doctor" just contradicted himself. It should read that IS expected, because decreased insulin production would make your c-peptide level low. I guess that's what you get when you pay people to write a report that they have no say in...

Anyway, aside from the idiotic letter, it seems your best recourse now is to either find a patient advocate (see following link) or assault them with a stack of studies - or both. I did some digging and found a good bit of stuff regarding the pump being used in CF patients, all with great success. Also attached a few studies involving Type 1 patients, which I suppose your doctor could claim you are analogous to, since you are dependent on insulin.

Awesome article about how to deal with insurance companies (look at the section about Advocates):

<a target=_blank class=ftalternatingbarlinklarge href="http://www.health.com/health/article/0,23414,1663353,00.html
">http://www.health.com/health/a...1663353,00.html
</a>

Mention the pump specifically:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.imj.ie//Issue_detail.aspx?pid=838&type=Papers&searchString=diabetes%20cystic%20fibrosis
">http://www.imj.ie//Issue_detai...stic%20fibrosis
</a>
<a target=_blank class=ftalternatingbarlinklarge href="http://www.liebertonline.com/doi/pdf/10.1089/dia.2007.0238
">http://www.liebertonline.com/d...9/dia.2007.0238
</a>

Related to insulin requirements:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.ncbi.nlm.nih.gov/pubmed/11529531
">http://www.ncbi.nlm.nih.gov/pubmed/11529531
</a>

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C3K7PC-1J&_user=10&_coverDate=02%2F28%2F1994&_alid=690028626&_rdoc=4&_fmt=summary&_orig=mlkt&_cdi=6952&_sort=v&_st=17&_docanchor=&view=c&_ct=47070&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=073d32147a9bfc6ee21615f2c8d3e100
">http://www.sciencedirect.com/s...21615f2c8d3e100
</a>

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WCM-45FCHCN-1H&_user=10&_coverDate=04%2F30%2F2000&_alid=690028626&_rdoc=56&_fmt=summary&_orig=mlkt&_cdi=6742&_st=17&_docanchor=&view=c&_ct=47070&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=02c57c922b9486e9dc0d6743f9d0099c
">http://www.sciencedirect.com/s...c0d6743f9d0099c
</a>

Studies I can't find the full text for (for free, anyway):

<a target=_blank class=ftalternatingbarlinklarge href="http://www.cysticfibrosisjournal.com/article/S1569-1993(05)00117-7/abstract
">http://www.cysticfibrosisjourn...0117-7/abstract
</a>

Journal of Cystic Fibrosis, Volume 5, Supplement 1, 2006
A272/S63 Use of continuous subcutaneous glucose monitoring system (CSGMS) in the management of CFRD: the CFRD team and patient perspective
M. Butler1, R. Driver2, C. Elston1, G.A. Hitman2, L.M. Kuitert1.
1Adult CF Service, London Chest Hospital, 2Department of Diabetes, Royal London Hospital, London, UK

Some general studies about pumps used in Type 1 Diabetes:

<a target=_blank class=ftalternatingbarlinklarge href="http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=88324&Ausgabe=231258&ProduktNr=224036&filename=88324.pdf
">http://content.karger.com/Prod...ename=88324.pdf
</a>
P1-555 Pg 163
P1-546 Pg 161

Good luck, from the sounds of that letter you'll probably need it. <img src=""> <img src="">

Sevenstars · Feb 15, 2008

<div class="FTQUOTE"><begin quote>Originally posted by: SaltyAndSweet Her C-peptide level is within nomal limits, which is not expected, since cystic fibrosis is associated with impared glucose tolerance rather than primarily decreased insulin production."</end quote></div>

First of all, this sentence makes no sense at all - their "doctor" just contradicted himself. It should read that IS expected, because decreased insulin production would make your c-peptide level low. I guess that's what you get when you pay people to write a report that they have no say in...

Anyway, aside from the idiotic letter, it seems your best recourse now is to either find a patient advocate (see following link) or assault them with a stack of studies - or both. I did some digging and found a good bit of stuff regarding the pump being used in CF patients, all with great success. Also attached a few studies involving Type 1 patients, which I suppose your doctor could claim you are analogous to, since you are dependent on insulin.

Awesome article about how to deal with insurance companies (look at the section about Advocates):

<a target=_blank class=ftalternatingbarlinklarge href="http://www.health.com/health/article/0,23414,1663353,00.html
">http://www.health.com/health/a...1663353,00.html
</a>

Mention the pump specifically:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.imj.ie//Issue_detail.aspx?pid=838&type=Papers&searchString=diabetes%20cystic%20fibrosis
">http://www.imj.ie//Issue_detai...stic%20fibrosis
</a>
<a target=_blank class=ftalternatingbarlinklarge href="http://www.liebertonline.com/doi/pdf/10.1089/dia.2007.0238
">http://www.liebertonline.com/d...9/dia.2007.0238
</a>

Related to insulin requirements:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.ncbi.nlm.nih.gov/pubmed/11529531
">http://www.ncbi.nlm.nih.gov/pubmed/11529531
</a>

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C3K7PC-1J&_user=10&_coverDate=02%2F28%2F1994&_alid=690028626&_rdoc=4&_fmt=summary&_orig=mlkt&_cdi=6952&_sort=v&_st=17&_docanchor=&view=c&_ct=47070&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=073d32147a9bfc6ee21615f2c8d3e100
">http://www.sciencedirect.com/s...21615f2c8d3e100
</a>

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WCM-45FCHCN-1H&_user=10&_coverDate=04%2F30%2F2000&_alid=690028626&_rdoc=56&_fmt=summary&_orig=mlkt&_cdi=6742&_st=17&_docanchor=&view=c&_ct=47070&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=02c57c922b9486e9dc0d6743f9d0099c
">http://www.sciencedirect.com/s...c0d6743f9d0099c
</a>

Studies I can't find the full text for (for free, anyway):

<a target=_blank class=ftalternatingbarlinklarge href="http://www.cysticfibrosisjournal.com/article/S1569-1993(05)00117-7/abstract
">http://www.cysticfibrosisjourn...0117-7/abstract
</a>

Journal of Cystic Fibrosis, Volume 5, Supplement 1, 2006
A272/S63 Use of continuous subcutaneous glucose monitoring system (CSGMS) in the management of CFRD: the CFRD team and patient perspective
M. Butler1, R. Driver2, C. Elston1, G.A. Hitman2, L.M. Kuitert1.
1Adult CF Service, London Chest Hospital, 2Department of Diabetes, Royal London Hospital, London, UK

Some general studies about pumps used in Type 1 Diabetes:

<a target=_blank class=ftalternatingbarlinklarge href="http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=88324&Ausgabe=231258&ProduktNr=224036&filename=88324.pdf
">http://content.karger.com/Prod...ename=88324.pdf
</a>
P1-555 Pg 163
P1-546 Pg 161

Good luck, from the sounds of that letter you'll probably need it. <img src=""> <img src="">

Sevenstars · Feb 15, 2008

<div class="FTQUOTE"><begin quote>Originally posted by: SaltyAndSweet Her C-peptide level is within nomal limits, which is not expected, since cystic fibrosis is associated with impared glucose tolerance rather than primarily decreased insulin production."</end quote>

First of all, this sentence makes no sense at all - their "doctor" just contradicted himself. It should read that IS expected, because decreased insulin production would make your c-peptide level low. I guess that's what you get when you pay people to write a report that they have no say in...

Anyway, aside from the idiotic letter, it seems your best recourse now is to either find a patient advocate (see following link) or assault them with a stack of studies - or both. I did some digging and found a good bit of stuff regarding the pump being used in CF patients, all with great success. Also attached a few studies involving Type 1 patients, which I suppose your doctor could claim you are analogous to, since you are dependent on insulin.

Awesome article about how to deal with insurance companies (look at the section about Advocates):

<a target=_blank class=ftalternatingbarlinklarge href="http://www.health.com/health/article/0,23414,1663353,00.html
">http://www.health.com/health/a...1663353,00.html
</a>

Mention the pump specifically:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.imj.ie//Issue_detail.aspx?pid=838&type=Papers&searchString=diabetes%20cystic%20fibrosis
">http://www.imj.ie//Issue_detai...stic%20fibrosis
</a>
<a target=_blank class=ftalternatingbarlinklarge href="http://www.liebertonline.com/doi/pdf/10.1089/dia.2007.0238
">http://www.liebertonline.com/d...9/dia.2007.0238
</a>

Related to insulin requirements:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.ncbi.nlm.nih.gov/pubmed/11529531
">http://www.ncbi.nlm.nih.gov/pubmed/11529531
</a>

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C3K7PC-1J&_user=10&_coverDate=02%2F28%2F1994&_alid=690028626&_rdoc=4&_fmt=summary&_orig=mlkt&_cdi=6952&_sort=v&_st=17&_docanchor=&view=c&_ct=47070&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=073d32147a9bfc6ee21615f2c8d3e100
">http://www.sciencedirect.com/s...21615f2c8d3e100
</a>

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WCM-45FCHCN-1H&_user=10&_coverDate=04%2F30%2F2000&_alid=690028626&_rdoc=56&_fmt=summary&_orig=mlkt&_cdi=6742&_st=17&_docanchor=&view=c&_ct=47070&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=02c57c922b9486e9dc0d6743f9d0099c
">http://www.sciencedirect.com/s...c0d6743f9d0099c
</a>

Studies I can't find the full text for (for free, anyway):

<a target=_blank class=ftalternatingbarlinklarge href="http://www.cysticfibrosisjournal.com/article/S1569-1993(05)00117-7/abstract
">http://www.cysticfibrosisjourn...0117-7/abstract
</a>

Journal of Cystic Fibrosis, Volume 5, Supplement 1, 2006
A272/S63 Use of continuous subcutaneous glucose monitoring system (CSGMS) in the management of CFRD: the CFRD team and patient perspective
M. Butler1, R. Driver2, C. Elston1, G.A. Hitman2, L.M. Kuitert1.
1Adult CF Service, London Chest Hospital, 2Department of Diabetes, Royal London Hospital, London, UK

Some general studies about pumps used in Type 1 Diabetes:

<a target=_blank class=ftalternatingbarlinklarge href="http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=88324&Ausgabe=231258&ProduktNr=224036&filename=88324.pdf
">http://content.karger.com/Prod...ename=88324.pdf
</a>
P1-555 Pg 163
P1-546 Pg 161

Good luck, from the sounds of that letter you'll probably need it. <img src=""> <img src="">

Sevenstars · Feb 15, 2008

<div class="FTQUOTE"><begin quote>Originally posted by: SaltyAndSweet Her C-peptide level is within nomal limits, which is not expected, since cystic fibrosis is associated with impared glucose tolerance rather than primarily decreased insulin production."</end quote>

First of all, this sentence makes no sense at all - their "doctor" just contradicted himself. It should read that IS expected, because decreased insulin production would make your c-peptide level low. I guess that's what you get when you pay people to write a report that they have no say in...

Anyway, aside from the idiotic letter, it seems your best recourse now is to either find a patient advocate (see following link) or assault them with a stack of studies - or both. I did some digging and found a good bit of stuff regarding the pump being used in CF patients, all with great success. Also attached a few studies involving Type 1 patients, which I suppose your doctor could claim you are analogous to, since you are dependent on insulin.

Awesome article about how to deal with insurance companies (look at the section about Advocates):

<a target=_blank class=ftalternatingbarlinklarge href="http://www.health.com/health/article/0,23414,1663353,00.html
">http://www.health.com/health/a...1663353,00.html
</a>

Mention the pump specifically:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.imj.ie//Issue_detail.aspx?pid=838&type=Papers&searchString=diabetes%20cystic%20fibrosis
">http://www.imj.ie//Issue_detai...stic%20fibrosis
</a>
<a target=_blank class=ftalternatingbarlinklarge href="http://www.liebertonline.com/doi/pdf/10.1089/dia.2007.0238
">http://www.liebertonline.com/d...9/dia.2007.0238
</a>

Related to insulin requirements:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.ncbi.nlm.nih.gov/pubmed/11529531
">http://www.ncbi.nlm.nih.gov/pubmed/11529531
</a>

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN4-4C3K7PC-1J&_user=10&_coverDate=02%2F28%2F1994&_alid=690028626&_rdoc=4&_fmt=summary&_orig=mlkt&_cdi=6952&_sort=v&_st=17&_docanchor=&view=c&_ct=47070&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=073d32147a9bfc6ee21615f2c8d3e100
">http://www.sciencedirect.com/s...21615f2c8d3e100
</a>

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WCM-45FCHCN-1H&_user=10&_coverDate=04%2F30%2F2000&_alid=690028626&_rdoc=56&_fmt=summary&_orig=mlkt&_cdi=6742&_st=17&_docanchor=&view=c&_ct=47070&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=02c57c922b9486e9dc0d6743f9d0099c
">http://www.sciencedirect.com/s...c0d6743f9d0099c
</a>

Studies I can't find the full text for (for free, anyway):

<a target=_blank class=ftalternatingbarlinklarge href="http://www.cysticfibrosisjournal.com/article/S1569-1993(05)00117-7/abstract
">http://www.cysticfibrosisjourn...0117-7/abstract
</a>

Journal of Cystic Fibrosis, Volume 5, Supplement 1, 2006
A272/S63 Use of continuous subcutaneous glucose monitoring system (CSGMS) in the management of CFRD: the CFRD team and patient perspective
M. Butler1, R. Driver2, C. Elston1, G.A. Hitman2, L.M. Kuitert1.
1Adult CF Service, London Chest Hospital, 2Department of Diabetes, Royal London Hospital, London, UK

Some general studies about pumps used in Type 1 Diabetes:

<a target=_blank class=ftalternatingbarlinklarge href="http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=88324&Ausgabe=231258&ProduktNr=224036&filename=88324.pdf
">http://content.karger.com/Prod...ename=88324.pdf
</a>
P1-555 Pg 163
P1-546 Pg 161

Good luck, from the sounds of that letter you'll probably need it. <img src=""> <img src="">

Sevenstars · Feb 15, 2008

/cry

some of those links don't work, but it's almost 5am and I can't edit my post for some reason.

I'll PM or fix tomorrow.

Everyone should look at this one though - it's a good read.

(I hope it works this time)

<a target=_blank class=ftalternatingbarlinklarge href="http://www.health.com/health/article/0,23414,1663353,00.html">Insurance</a>

Sevenstars · Feb 15, 2008

/cry

some of those links don't work, but it's almost 5am and I can't edit my post for some reason.

I'll PM or fix tomorrow.

Everyone should look at this one though - it's a good read.

(I hope it works this time)

<a target=_blank class=ftalternatingbarlinklarge href="http://www.health.com/health/article/0,23414,1663353,00.html">Insurance</a>

Sevenstars · Feb 15, 2008

/cry

some of those links don't work, but it's almost 5am and I can't edit my post for some reason.

I'll PM or fix tomorrow.

Everyone should look at this one though - it's a good read.

(I hope it works this time)

<a target=_blank class=ftalternatingbarlinklarge href="http://www.health.com/health/article/0,23414,1663353,00.html">Insurance</a>

Sevenstars · Feb 15, 2008

/cry

some of those links don't work, but it's almost 5am and I can't edit my post for some reason.

I'll PM or fix tomorrow.

Everyone should look at this one though - it's a good read.

(I hope it works this time)

<a target=_blank class=ftalternatingbarlinklarge href="http://www.health.com/health/article/0,23414,1663353,00.html">Insurance</a>

Sevenstars · Feb 15, 2008

/cry

some of those links don't work, but it's almost 5am and I can't edit my post for some reason.

I'll PM or fix tomorrow.

Everyone should look at this one though - it's a good read.

(I hope it works this time)

<a target=_blank class=ftalternatingbarlinklarge href="http://www.health.com/health/article/0,23414,1663353,00.html">Insurance</a>

SaltyAndSweet · Feb 15, 2008

oops... sorry. the letter said:
"which is not UNexpected"
I'll recheck to make sure I didn't make any other typeos. <img src="i/expressions/face-icon-small-sad.gif" border="0">

Just got off the phone with my doctor. She is going to call the Medical Director at my insurance company hoping that an explanation/education of CFRD will change their minds about the decision. (Along with hitting them from all the other angles possible).

Sevenstars, thank you soooo much for all your help!

SaltyAndSweet · Feb 15, 2008

oops... sorry. the letter said:
"which is not UNexpected"
I'll recheck to make sure I didn't make any other typeos. <img src="i/expressions/face-icon-small-sad.gif" border="0">

Just got off the phone with my doctor. She is going to call the Medical Director at my insurance company hoping that an explanation/education of CFRD will change their minds about the decision. (Along with hitting them from all the other angles possible).

Sevenstars, thank you soooo much for all your help!

SaltyAndSweet · Feb 15, 2008

oops... sorry. the letter said:
"which is not UNexpected"
I'll recheck to make sure I didn't make any other typeos. <img src="i/expressions/face-icon-small-sad.gif" border="0">

Just got off the phone with my doctor. She is going to call the Medical Director at my insurance company hoping that an explanation/education of CFRD will change their minds about the decision. (Along with hitting them from all the other angles possible).

Sevenstars, thank you soooo much for all your help!

SaltyAndSweet · Feb 15, 2008

oops... sorry. the letter said:
"which is not UNexpected"
I'll recheck to make sure I didn't make any other typeos. <img src="i/expressions/face-icon-small-sad.gif" border="0">

Just got off the phone with my doctor. She is going to call the Medical Director at my insurance company hoping that an explanation/education of CFRD will change their minds about the decision. (Along with hitting them from all the other angles possible).

Sevenstars, thank you soooo much for all your help!

SaltyAndSweet · Feb 15, 2008

oops... sorry. the letter said:
"which is not UNexpected"
I'll recheck to make sure I didn't make any other typeos. <img src="i/expressions/face-icon-small-sad.gif" border="0">

Just got off the phone with my doctor. She is going to call the Medical Director at my insurance company hoping that an explanation/education of CFRD will change their minds about the decision. (Along with hitting them from all the other angles possible).

Sevenstars, thank you soooo much for all your help!

Insurance denied coverage again

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