Reconsideration??

Has anyone heard of having your dr. call and request a reconsideration prior to filing an appeal for a denial? I spoke with BCBS today and the customer service rep said that I could ask the dr. to send in better background information and medical records and ask that the authorization dept. "reconsider" my request for surgery. I have never heard of this before and am lost as to what to do now. HELP!!!

It is possible for the Dr. to request a reconsideration of the initial denial of authorization. However, I would look at the denial notice/letter and see what the specifics were about the denial and ensure that when the Dr. asks for reconsideration he specifically addresses those issues that BCBS felt was lacking. I would also ask BCBS what appeal rights are available after the Dr. requests reconsideration and if the reconsideration is not overturned in your favor. Make sure that his request for reconsideration does not exhaust all appeal avenues, otherwise you may only get one bite at the apple! If you only get one shot, I would ask to see if you can participate in the reconsideration process with him, maybe have your primary care physician add information if you are considering having WLS by another physician, add more medical history, etc. Good Luck! Carla Clark