Question:
HAS ANYONE EVER WON APPEALS WITH UHC?

Has anyone who has United Health Care -Select EPO ever won their appeal? I am currently appealing United Heath Care - Select EPO for abdominoplasty 15831 and brachioplasty 15836. I was denied 02/21/03.The letter says the following: AT&T Broadband benefit plan excludes:Cosmetic procedures or services that change or improve appearance w/out significantly improving physiological function. As we all know the procedures I am in need of are reconstructive after massive weight loss. I have letters from my PCP, WLS surgeon, Reconstructive surgeon, Chiropractor, Dermatologist stating the overhanging pannus of the lower abdomen, rashes, infections, back pain, neck pain, shoulder pain, hygiene issues, and problems with living a normal life because of all the skin. I have requested that an ASPS(American Society of Plastic Surgeons) surgeon review my case. It only makes sense that a plastic surgeon instead of a general surgeon review my appeal, as they had a general surgeon review my original pre determination and you saw what happened. How can you have someone who is not an expert on the matter review my case? If anyone has had to fight United Health Care - Select EPO or any type of insurance at United Health Care with similar denial wording please email me: [email protected] Thank you for your assistance.    — Teena A. (posted on March 24, 2003)

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