I recieved this letter today- and would love anyones input:
Re:  an ill premature infant ( version of Dr. Nieferts letter had been
submitted with weights, condition, gestational age)
Dear Madam:
We are in receipt of you letter dated 5/3/00 regarding reimbursement for the
proposed breast pump.

The medical staff reviewed the documentation submitted. The breast pump is
not a reimbursable item under the plan.

Medical equipment qualifies as durable medical equipment eligible for
reimbursement under the plan if it meets all of the following criteria:
1.  It can withstand repeated use.
2.  It is not disposable.
3.  It is used to serve a medical purpose.
4.  It is generally not usefull to a person in the absence of a sickness or
injury.
5.  It is appropriate for use in the home.

The breast pump does not qualify as durable medical equipment eligible for
reimbursement as it does not meet criteria #4 in the above definition. The
breast pump can be useful to aperson in absence of sickness or injury.

There is the right to a further appeal of theis determination. To do so,
please submit the following medical information within (60) days of receipt
of this notice.

*Clinical documentation to substatiate the above noted criteriea for duable
medical equipment has been met.
the rest of the letter decribed where to send the information
Thanks
Karen Querna, RN, BSN, IBCLC
Spokane, WA

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