What was your criteria and requirements before your Healthcare Provider/Doctor ok’d use of CGMS (Continuos Glucose Monitoring System) with CSII (IPT-Insulin Pump Therapy)
What was the: Criteria and Requirements You had to comly with before Healthcare Provider/Doctor ok’d use or
issued of RX for CGMS.
Classes (Educational Requirements if any at all)
Time Frame (From of Request of CGMS Therapy to sync to pump and to day to day monitoring)
Require a Signed Contract with Diabetes Care Team or Doctors if needed or required.
Concerns (Pros & Cons) of CGMS expressed by Doctor and Diabetic Care Team
No terms at all. No classes. I just asked to go on the pump and cgms and they helped to do all of the paperwork. I received all of my training from the pump company (but I had done a lot of reading and learning on my own pre start). No.concerns at all. My endo is very progressive and was happy I was moving forward towards the pump.
For my Health care team, the requirements are classes (if you are with medtronic you would use the online class) I was also told I had to experiece a certain amount of lows every month before I’m approved for one or suffer from severe Hypo unawareness. My insurance covered almost all of the costs for my pump and supplies but they are being very funny about a CGM. Hopefully your team isnt like mine!
My endo did not have any pre CGMS requirements however my insurance sure did.
My insurance required documentation of adequate blood sugar monitoring,(ie 4 or more times a day), diabetes education, and either hypoglycemia unawareness or multiple lows below 50. I’ve heard of some insurances requiring an I-Pro study. Oh and also either pump therapy or MDI as far as insulin regimen goes.
I’m actually going through this process right now! I haven’t had any requirements to be able to be OK’d for a pump and a CGM on my endo’s side of things. My endo says it is the “standard of care for Type 1 diabetes” and was ecstatic that I wanted to switch to those from MDI. As for my insurance, they just needed a letter of medical necessity from my endo. From the time I started the process of picking pumps/CGMs to when I will be pumping/CGM-ing will be a little over a month. My endo has me signed up for an hour and a half “training session” when I start my CGM and my pump. I’ve already pumped in the past (I took a hiatus from pumping for a few years and am starting again), so mostly I will just be learning new pump features and learning how to use my CGM.
I went thru my PCP for both CGMS and pump. I didn’t have any requirements. My insurance originally turned down the CGMS but I appealed it and won. I am hypo-unaware and was having a lot of bad lows and passing out.
I did not have any classes. I went to a brief training session for the pump to get started at a local diabetes center – it was less than an hour. They signed me up for a blood glucose management program with Animas to help me get pump settings adjusted but I did not use that.
I just got my cgm after a 6 week fight with…the cgm company. No kidding. my endo was for it and gave me the info to contact the cgm company. They said requested tons of info from my endo and logs from me (needed to show 4 instances of hypos under 60 in 30 days - I at least doubled that number in the logs).
The cgm rep wasn’t happy with the info (she wanted to be sure it was a “slam dunk”) so she would not send it to my insurance until my doctor wrote a long narrative letter requesting it (my records and logs evidently were not enough). However, once it went to my insurance, it was approved within 2 hours. Now I just need to schedule the training with my CDE. I’m very frustrated with the whole process, but I suppose it is a necessary evil to get the cgm.
If you’re referring to the medical team side, nothing, I don’t think I even mentioned it to my Doctor, just called Dexcom and set up a meeting, filled out their paperwork and next thing I knew it was done. If you’re refering to the insurance side, it was still nothing but it was HAP insurance at the time. This year we have BCBS and it wasn’t covered at all, I have the BCBS rep and HR people at my husbands job to thank, they put in all the work to continue the coverage.
Sorry for long responce but I am frustrated beyond Frustrated the REAL WORLD has no problem but the Veteran’s Affairs Medical has this PURE… absolute PURE look on what they view necessary!!! They say CGMS arent Necessary!!! I say BUNK pure point blank BUNK!!!
In the process for my son. Last Friday endo took our paperwork, med. necessity for her to fill out and 30-day BG log. He has left the honeymoon phase recently and with teenage human growth hormone at full throttle, his readings have been averaging pretty high. So Im a little worried that because of that, he hasn’t had those necessary lows they like to see in the logs, that they wont approve it. We want it to help change his doses, and test them, plus he’s going to be driving soon and doing some more sports. My husband and I would feel more at easy if he could know his numbers more often. Have BCBS, they covered his Omnipod 100%, but we have no idea where they stand on the CGMs or possibly his age being a factor. Hopeing its all good.
