Back in July the CGMS was denied for me by my insurance after they stated to me they review on a case by case basis, then when I asked for coverage they stated they don’t cover that type of medical equipment and did not even give me a claim number to file an appeal. The claim # was listed as N/A on this lame denial letter.
I wrote a very lengthy letter and supplied 21 pages of literature for my appeal at the end of September and never heard anything from them.
I called last Friday and they stated they never received the appeal and I left my name for the appeal lady to call me. She never did. I called again on Tuesday and left a voice mail with the appeal lady Donna, and of course I never heard from her. I then gathered my letter and 40 pages of documentation, this time, and faxed my appeal into the insurance company and called them two hours later and no, no fax as yet, omg. Julie T. (she would not give me her last name) finally recieved the fax and said what do you know they got the mailed appeal on the same day, fancy that!!!
She told me they meet for appeals twice a month and I asked when the next one was and she stated she did not know, I said give me someone who knows that info. She put me on hold for a long time and came back that it would be in the next 30-60 days, how the heck does that equate to twice a month??!!
I have a pumper friend who stated that I can file a complaint with the state about how this insurance company is messing with me, but I think they realize there wrong doing after they finally got the mail a month later.