How to do a Second Appeal to Anthem Blue Cross?

Hi, I have done a first appeal and have been denied. I now need to do a second appeal and I do not know what they are asking for. I have asked my doctors for letters to back up my request but what else do I need? All help is welcomed. Thank you, Louise

hi, call Anthem , ask for utilization review and then ask for a case manager...they CAN NOT hide from you forever....explain that you (and your employer) would like to know why you are being denied and what needs to be presented for your case to be approved.{{{{{I was told this helps by a friend who worked there as a case manager}}}}....My employer got mine approved so there is always that route but I am told that was a one in a million shot....who knows...maybe lightining can strike twice...Good Luck!!!!___drea

I have anthem and they denied me the first time. For some reason they had the wrong codes. The first thing I did was call utilization review. Be assertive! I also requested the policy specifics to be sent to me. With that policy in my hands I started my appeal. Fortunately I didn't need the appeal. Don't let this get you down. They do approve the Gastric Bypass. I have also seen posts from people that wanted the band and they have had it approved. Blessings spplendalicious

You need to get the policy in writing and find out exactly what the criteria for surgery is. Are you a State employee? Usually Anthem is pretty good - so I don't know where the communication is breaking down. Definitely get a supervisor, case manager whatever on the phone not just some trained monky CSR who can't do anything but read off a screen Good luck- don't tak eno for an answer- who is the surgeon?.