My reason....

johnp503 — Wed, 02 Jul 2008 14:39:15 +0000

I wanted the unit that I could move on with. I'm starting with the Medtronic Guardian. In the future I may have to progress on to a pump and Medtronic makes a pump which works with the sensor that I am currently using. Medtronic is the oldest company in the business so that is a plus also. johnp503

Welcome to CGMS Central. Our mission is to be the resource on the web for anything about CGMS reimbursement.

link — Fri, 07 Sep 2007 19:53:39 +0000

Start a Forum thread for discussion purposes. Then, create a Wiki Page for documenting the factual information that the patient filling the claim needs in order to streamline the process (who did you talk to at the carrier? and what was their phone # or email address?) and ensure more successful claims.

If you are not sure where to get started with reimbursement, check out our FAQ.

We hope you join our community and help move CGMS reimbursement along.

Welcome to CGMS Central. Our mission is to be the resource on the web for anything about CGMS reimbursement.

link — Fri, 07 Sep 2007 19:53:39 +0000

If you are not sure where to get started with reimbursement, check out our FAQ.

We hope you join our community and help move CGMS reimbursement along.

Welcome to CGMS Central. Our mission is to be the resource on the web for anything about CGMS reimbursement.

link — Fri, 07 Sep 2007 19:53:39 +0000

If you are not sure where to get started with reimbursement, check out our FAQ.

We hope you join our community and help move CGMS reimbursement along.

Thu, 01 Jan 1970 00:00:00 +0000

n/a

My reason....

johnp503 — Wed, 02 Jul 2008 14:39:15 +0000

Welcome to CGMS Central. Our mission is to be the resource on the web for anything about CGMS reimbursement.

link — Fri, 07 Sep 2007 19:53:39 +0000

If you are not sure where to get started with reimbursement, check out our FAQ.

We hope you join our community and help move CGMS reimbursement along.

Insurance Carriers Who Cover CGMS

link — Fri, 07 Sep 2007 21:13:21 +0000

Insurance Carriers Who Cover CGMS

link — Fri, 07 Sep 2007 21:13:21 +0000

DexCom Sales Reps

link — Fri, 07 Sep 2007 21:13:51 +0000

Insurance Carriers Who Cover CGMS

link — Fri, 07 Sep 2007 21:13:21 +0000

Insurance Carriers Who Cover CGMS

link — Fri, 07 Sep 2007 21:13:21 +0000

Thu, 01 Jan 1970 00:00:00 +0000

n/a

How do I go about obtaining insurance coverage for CGMS?

link — Fri, 07 Sep 2007 19:38:16 +0000

How do I go ...

Welcome to CGMS Central. Our mission is to be the resource on the web for anything about CGMS reimbursement.

link — Fri, 07 Sep 2007 19:53:39 +0000

If you are not sure where to get started with reimbursement, check out our FAQ.

We hope you join our community and help move CGMS reimbursement along.

CGMS Billing Codes

Lahle — Tue, 01 Jul 2008 15:10:45 +0000

If you do not use the proper billing codes, you can forget CGMS. When your doctor contacts your insurance company, be sure s/he uses the right billing codes.

A9276 for the sensor

A9277 for the transmitter

A9278 for the receiver

CGMS Billing Codes

Lahle — Tue, 01 Jul 2008 15:10:45 +0000

If you do not use the proper billing codes, you can forget CGMS. When your doctor contacts your insurance company, be sure s/he uses the right billing codes.

A9276 for the sensor

A9277 for the transmitter

A9278 for the receiver

BCBS of Michigan (MICHILD)

curtis596 — Sat, 26 Jul 2008 19:02:54 +0000

I just received reimbursement from BCBS of Michigan (MICHILD). I simply called and asked for the reimbursement form, filled it out and sent it in with appropriate documentation. At first it was denied due to lack of prescription, which wasn't so, so I faxed a copy over right away. Approximately a month later I got a check and a letter stating it was approved.

My reason....

johnp503 — Wed, 02 Jul 2008 14:39:15 +0000

Blue Cross and Blue Shield of Ohio

WindyCobourne — Fri, 04 Jul 2008 18:38:27 +0000

I have not received reimbursement yet. My claim has been pending since January. I call about once every 3 weeks to check on it, so they have on record that I am being persistent. The latest is that it is under medical review and I should have an answer by July 17th, 2008. Currently all I have submitted is my letter of medical necessity from my endocrinologist. I will update when I hear results. If anyone else has had acceptance or denial from this same insurance company. Please share your experiences with me! Thanks!

Blue Cross and Blue Shield of Ohio

WindyCobourne — Fri, 04 Jul 2008 18:38:27 +0000

Disallowed by Horizon BC/BS of NJ: "investigational"

tedlevy — Fri, 11 Jul 2008 18:24:42 +0000

"This letter is in reference to your appeal request for reconsideration of our denial of the above referenced claim (procedure codes A9278, A9276, and A9277)

Your appeal has been reviewed by our Medical Director, Dr. STanley E. Harri. The sensor and transmitter are consideered [sic] investigational.

Therefore, the above claim is not eligible for reimbursement.

We regret that a more favorable decision cannot be reached; however, benefits can only be extended in accordance with our established medical policy guidelines.

Sincerely,

[signed}

Paul Zoblitz

Disallowed by Horizon BC/BS of NJ: "investigational"

tedlevy — Fri, 11 Jul 2008 18:24:42 +0000

"This letter is in reference to your appeal request for reconsideration of our denial of the above referenced claim (procedure codes A9278, A9276, and A9277)

Your appeal has been reviewed by our Medical Director, Dr. STanley E. Harri. The sensor and transmitter are consideered [sic] investigational.

Therefore, the above claim is not eligible for reimbursement.

We regret that a more favorable decision cannot be reached; however, benefits can only be extended in accordance with our established medical policy guidelines.

Sincerely,

[signed}

Paul Zoblitz

How long have you been insured by this policy?

link — Fri, 07 Sep 2007 19:54:05 +0000

...

Medical Plans that Approve CGMS

Steve The Diabetic — Fri, 25 Apr 2008 18:51:59 +0000

Does anyone have a list of medical providers that have approved a CGMS for continuous use as a medical necessity without having to get all kinds of documentation and a letter from your doctor?