Denial is a river in Egypt?

Yes we got the "dreaded" denial call. I don't get this.  We have an 8500 deductible.  So if you make us wait 6 mos (the reasoning was that she hasn't been on insulin shots long enough- but wouldn't her endo actually be the better one to make that call insurance company?) - we get the pump FREE...all supplies free, etc because by then we will most likely have maxed out our deductible (we already are 3300 into it!).  But if we get it now and they approve it....we pay $1666 out of pocket.  Well played insurance company- well played......

Is it a tragedy if she doesn't get it?  To Katie yes- so for that reason alone I want it.  But truly her numbers are all over still....we are worrying about that dreaded under 100 blood sugar.  She's now working full time and her numbers are just wildly swinging.  Today she was 70 at one point.  And she's not really thinking clearly then.  She's not wanting to take time to deal with it..because as she says she's FINE...well she's 18 and invincible- but yet she's fragile...super fragile.

Anyway- the next step after denial is a peer-to-peer- her doctor talks to the insurance doctor to explain why they want the pump and so fast.  I don't know what the recourse is after if she's still denied.  I don't  know if because the reasoning is it hasn't been 6 mos that they will just resubmit it again in 6 mos?

And then we found out that the Dexcom Continuous Glucose Monitor (CGM) wasn't approved for sure yet either....we thought that it was since we submitted a payment plan.  So now we wait for that also.  Fingers crossed this one goes through.  With her numbers so all over the place- this device will be crucial in seeing her trends and also for notifying her if she has high or low blood sugar- which means she will sleep better at night.

We are hoping to re-carpet the basement bedroom (where she sleeps- lost carpeting in basement in flood a few months back) to make her room better....but that won't be instantaneously.

I don't get why the insurance company is so obnoxious about things either- why deny us her test strips? I don't get it.  Esp when your discount means I pay $100 over $112 or something stupid.  Why does every step require four steps back?  What do they think we are doing with her test strips?  What do they think will be the problem with us getting a pump??

I'll keep you all posted on how things progress after the peer-to-peer.  Hoping our Dr. Kassar is as persuasive as he seems!