Frequently Asked Questions
Introduction to CGMS
The focus of this site is to help you obtain reimbursement for CGMS
- How do I go about obtaining insurance coverage for CGMS?
- Which CGMS are covered by my insurance?
- What parts of the cgms are covered and at what amounts?
- What State do you live in?
- Welcome to CGMS Central. Our mission is to be the resource on the web for anything about CGMS reimbursement.
- What is your insurance policy group #?
- How long have you been insured by this policy?
- What forms do I need to complete in order to obtain my CGMS?
- What is my explanation of medical necessity for needing the CGMS?
- What does my doctor need to do to assist me in ordering my CGMS?
Decisions you need to make
Other steps on the way to continuous glucose monitoring
- What are the different options in continuous glucose monitoring?
- What is continuous glucose monitoring?
Continuous Glucose Monitoring is a relatively new technology which allows a person to measure blood sugar levels in the human body every five minutes, twenty-four hours a day, and wirelessly transmit the data to a handheld device thus creating a maximum of 288 blood sugar checks each day.
Because the blood sugar checks are automated, alarms can also be set based on predefined thresholds for high and low levels which when exceeded alarm the user via an audible warning. Even while asleep, wearers of the CGMS can then be alerted to out of range blood sugar levels and take corrective action.
- What is diabetes?
Diabetes (diabetes mellitus): a condition characterized by hyperglycemia resulting from the body's inability to use blood glucose for energy. In type 1 diabetes, the pancreas no longer makes insulin and therefore blood glucose cannot enter the cells to be used for energy. In type 2 diabetes, either the pancreas does not make enough insulin or the body is unable to use insulin correctly.
- What is blood glucose monitoring?
Blood glucose monitoring is a process by which a person periodically checks their blood for its sugar content using a portable diagnostic device. Depending on many factors, this point in time measurement is then used in combination with several choices of actions which can be taken to influence blood sugar levels in the future to be within the person's target range. This series of measurements, assessment and actions together comprise blood glucose monitoring.
- How do I obtain a continuous blood glucose monitoring system (cgms)?
This technology is also becoming available in many countries around the world, each with their own requirements and regulations.
USA
- How do I go about obtaining insurance coverage for CGMS?
How do I go ...
- Which CGMS are covered by my insurance?
...
- What parts of the cgms are covered and at what amounts?
...
- What State do you live in?
California Massachusetts
- Welcome to CGMS Central. Our mission is to be the resource on the web for anything about CGMS reimbursement.
Start a Forum thread for discussion purposes. Then, create a Wiki Page for documenting the factual information that the patient filling the claim needs in order to streamline the process (who did you talk to at the carrier? and what was their phone # or email address?) and ensure more successful claims.
If you are not sure where to get started with reimbursement, check out our FAQ.
We hope you join our community and help move CGMS reimbursement along.
- What is your insurance policy group #?
...
- How long have you been insured by this policy?
...
- What forms do I need to complete in order to obtain my CGMS?
...
- What is my explanation of medical necessity for needing the CGMS?
....
- What does my doctor need to do to assist me in ordering my CGMS?
...
- What are my options in the event that my doctor does not want to support my desire to obtain a CGMS?
You can always find a new doctor who will be willing to work with you on a plan that you both can agree on. This site will help to identify those physicians who have embraced the new CGMS approach to real-time blood sugar monitoring and who are willing to work with new patients to secure their new CGMS.
- What do other people say about CGMS by vendor solution?
DexCom - Their new DexCom Seven system (featuring a 7 day sensor and water resistance) came out in Spring 2008.
Medtronic - Medtronic's new 522/722 insulin pumps are now equipped to receive input from a separately purchased system called the REAL-time CGMS also from Medtronic. I don't know if they are continuing manufacture and support for the Guardian RT CGMS.
Abbott (launching in Europe) (pending FDA marketing clearance in the USA - Not for Sale)