Decision on my Appeal

DENIED...again. Does not meet the medical criteria per the policy. I have to wait on the letter for the specific reason and next appeals step proccess. I asked the guy if there was someone I could speak to since my first denial was based on me losing and regaining and that was incorrect and I sent all documentation to show that....he said there was no one I could speak with right now....the letter would be more clear...would I like a copy of the policy...I said no thanks I have...I quoted the whole thing in my letter!!!! Sarah

How frustrating, but hang in there Sarah. I'm glad to hear that you are not giving up and you plan to resume the fight upon receiving your letter form BCBS. I will continue to keep you in my thoughts and prayers. Take care, GladysS

Sarah. I have BCBS of Illinois and my plastic surgeon got an approval from them for my last surgery. I do not know what he said but it worked. When I questioned him he said....do not take no for an answer and get someone else to review the file after the denial. It worked. Good luck. May be the doctor needs to do the submission.

Thanks, I already have my PS approved but I need to lose more weight still at 295 I need a revision. My surgeon and her office is absoluting no help...if I want something done right I have to do it myself.

Sarah, Just keep fighting the fight girl and don't give up! You have come this far so just keep rolling with it .. I HATE that you are even having to deal with this mess! It just ticks me off the games that so many of these insurance companies play with people. I wish your Dr.'s office was more helpful and that you didn't have to battle it seemingly alone!

Hi Sarah Margaret, Have you thought about contacting Obesitylaw.com? They are very successful in getting denials overturned. Just a thought. Good Luck, Julie

Sarah, I am sooo sorry that you were denied again! What in the heck is wrong with these crazy people. Your appeal letter would have convinced me if I had been the decisionmaker in your case. Keep on fighting girl! You have to! I'll be thinking about you and you will be in my prayers! Kat