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Author Topic: I hate you, insurance company, may have to switch endos  (Read 1044 times)

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Offline angieh

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I hate you, insurance company, may have to switch endos
« on: December 03, 2015, 02:18:25 PM »
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  • As some of you may recall, we switched endos about 6 months after W was diagnosed because a: they were jerks, b: they knew nothing (nor wanted to know anything) about our pump of choice, and c: had me keeping him in the 300's overnight while on MDI until I wised up and started making corrections on my own.

    We were able to switch to an endo in a different city, because there were no pediatric endos "in-network" on the health plan at that time.

    Now - there has been some changes and the endo that we hate is now in-network. Which means that they have denied our ongoing referral request and are telling us to go back to jackass endo.

    Our wonderful pedi has already conducted a peer-to-peer review as part of the grievance process, and unfortunately, the denial was upheld. I have written a formal letter of grievance to the insurance company, going into great detail with all the reasons I listed above as to why jackass endo is NOT in my son't best medical interest. They have not received my letter yet. I will be calling them every single day until they tell me it is recieved, or I will be hand-delivering it.

    Any advice?

     We are pretty much self-sufficient with the techncial stuff, but I would like to actually have an endo who we trust and share similar beliefs on d-management. If we have to switch to jackass endo, it's going to be the shortest visit in the world because all I will want is an A1c and then I'm out the door. No time for their BS.
    Mom to W 6yrs old, diagnosed T1 9-19-12

    Also mom to little Miss V, 2.5 years old, non-D


    Offline SarahMay

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    Re: I hate you, insurance company, may have to switch endos
    « Reply #1 on: December 03, 2015, 02:29:54 PM »
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  • Other parents here are a lot more experienced and tenacious with fighting the system so for now just  <hug> from me. Go get 'em!
    Sarah - wife to Aaron, mom to
    Matthew (9) non-D
    Jonah (8) DX 02/05/14 (Animas Ping, Dexcom)
    Isaiah (8) DX 01/10/13 (Animas Ping, Dexcom)
    Gideon (5) non-D

    Offline andrea

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    Re: I hate you, insurance company, may have to switch endos
    « Reply #2 on: December 04, 2015, 03:04:23 PM »
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  • What about our old awesome endo in Lacrosse  (Jane Korducki) is she in network?

    You could also visit
    « Last Edit: December 04, 2015, 03:11:49 PM by andrea »

    Mom to Annelies, 14 (Dx 18 Mar 08~Pumping MM Oct 08-May 12, Omnipod May 12-Aug 13. tSlim Aug 13+ ~Dexcom Oct 11), Katy, 18 (non-D) and Jory (non-D/US Navy)
    God created wine to keep Army Wives from taking over the world
    My blog

    Offline stefaniemsmith1

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    Re: I hate you, insurance company, may have to switch endos
    « Reply #3 on: December 07, 2015, 07:52:59 PM »
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  • That sucks! I'm sorry. Praying that you get approval.

    Wife to my hero, Kevin
    Mom to Mackenzie (14, T1, DX 9/17/12, Pinging Green)
    & Kayleigh (7, T1, DX 11/20/12, Podding)


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