EXTERNAL REVIEW
Hugo,
If it's insurance you are speaking of, please let me know. I was originally denied for the WLS and then the decision was overturned to Approved. All that happened in that process was that my surgeon had what is called a peer-to-peeer discussion on the phone with the doctor at my insurance company that had denied my surgery request.
Darla
Is this an appeal through the NYS Dept of Insurance? I have ghi and bcbs, I was denied and also 2 appeals denied. I went to the dept of insurance and was approved. Check out the insurance board there is alot of info and also a lawyer runs it and can advise you. If it's through the dept of insurance most people on that board were had their denials reversed through them. For me it was a reversal based on my pcp letter. In their denial they stated I was "specifically" denied due to that letter so I ended up putting a letter together and having my pcp sign it. I hope this helps.
Joy
thank you very much.i'm still on my first appeal and i should be hearing something from them anytime soon but, i'm preparing for a long battle.I also have GHI/BCBS.If you please.How long did it take from the time you submitted the paperwork to getting an approval fro the state? Thank you for all of the info.
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