You should be able to ask Minimed for copies of all of the documentation they got from your insurance.
The state insurance commissioner would be a good place to start in terms of an external agency.
Also just keep plugging away with the appeals process. I’d refax but also send a copy snail mail with something that has a tracking number or a return receipt that way you can prove someone there signed for it.
Sorry this is happening to you. It must be frustrating.
Diana
Another avenue of attack in favour of “medically necessary” is basal rate settings. If you have two or more basal rate settings (my son has six). Your doctor should be able to prove medical necessity. David was on MDI pre-pump using Levimir for long acting/basal which is similar to Lantus, and NovoRapid for carbs/bolus. Levimir is supposed to be a once a day shot for background insulin, but within the first three weeks of MDI David’s Levimir dosage had to be split and changed from once daily to a twice daily dosage as he was constantly waking with high BG’s and even the split dosage was not ideal.
With his pump, it was necessary to boost his basal dosage between 3 a.m. and 7 a.m. to get him to a point where he would have a target BG, some mornings, which is still, some mornings in year 3 of pumping and not all mornings. There is no way that we could have fine tuned Levemir on MDI to accomodate for this unless, I guess if he went to a 2 x a day and 2 x a night split bringing his minimum daily shots from 6 up to 8. Imagine that, a life-time of Mom getting up at 12:00 a.m. to inject Levimir, 6:00 a.m to inject, and then be able to leave the noon and 6:00 p.m. to David to handle when he’s awake.
Cheryl