Many health insurance companies routinely deny coverage to people who are prescribed a continuous glucose monitoring system (CGMS). This device allows people with diabetes to know their glucose level, and whether it is rising or falling, at one- or five-minute intervals. Although it can be particularly useful for people who experience hypoglycemia unawareness and can detect an insulin pump malfunction, some insurance providers classify a CGMS as unnecessary and “experimental.”
In response, Gina Capone at Diabetes Talkfest decided to name July 2 CGMS Denial Day—and then to extend it to CGMS Denial Week, ending Friday, July 4. The purpose of this observance is to put pressure on insurance companies by making the issue of CGMS coverage denial more public. This effort involves encouraging people to post personal stories about CGMS denial at tudiabetes.com, an online diabetes community. You can read more about CGMS Denial Day/Week here at Diabetes Talkfest.
For a guide to personally obtaining insurance coverage for a CGMS, visit this page from the Juvenile Diabetes Research Foundation International.
This blog entry was written by Editorial Assistant Quinn Phillips.
Gina and others are also using a free resource on the web located at http://cgmscentral.com
“Our mission is to provide resources to help people to get their Continuous Glucose Monitoring Systems (CGMS) reimbursed by their insurance companies”
This is a community driven site of the people, by the people and for the people to work together sharing their experiences (both successful and not successful yet) to expedite the reimbursement process. One of the most useful features is the ability for the community to create an evergreen encyclopedia around continuous glucose monitoring reimbursement for each and every insurance carrier at the health plan level - where the reimbursement decision gets made.
For example, you can upload your letters of medical necessity and appeals that you send as well as those denial letters that are all too common.
The site infrastructure (think yahoo groups only finely tuned for this specific purpose) is an offshoot from Diabetech’s research programs (my company) in the field of clinical trials donated to the community (no fees, advertising, lists, etc…).
People can read and post either as a registered user or anonymously while the community manages all of the content itself. Check it out and see for yourself if this is useful and tell others.
Talking about banding together is one thing - having a tool that makes it easy and effective is quite another which is probably why Gina is using this and telling others to do so also.
Posted by Kevin McMahon | Jul 04, 2008 at 11:55 am