I was denied

I found out today that my insurance Cigna PPO denied me because I do not have 2 professionally supervised weight loss programs for a minimum of 26 weeks. However...I do have Weigh****chers documentation from Feb 2002 to May 2003. I need help with an appeal letter. Is there any samples on this site?

Dear Sharon, Don't give up! I don't have your insurance but I was denied twice by my insurance. My WLS doc appealed their decision and they denied and then I wrote a letter. I explained that I did not have the 6 months of supervised nutrition documentation, but that I was at the end of the line as far as weight loss was concerned. My PCP sent in documentation that he had been following me for 18 months and that I was not able to lose weight due to my continued yo-yo dieting. Be honest and be firm with the insurance company. I hope this helps. I will include you on my prayer list....Brenda from Apopka.

Hi Sharon Sorry to hear about your denial, I too am waiting for approval thru Atena PPO. Here is a website address for another excellent WLS site, she does have a excellent letter form to follow or copy for a denial to insurance companys. www.gastricbypassfamily.com she has alot of interesting sites to look at. Good luck and keep us posted. Melinda

I am waiting too. Almost a month now since my packet 2was submitted. I haven't been denied yet but am preparing. Go to www.obesitylaw.com this man fights for you. I hope it helps. Email me [email protected] , MSN mesenger the same, or AIM Kelebeans123 Good Luck, God Bless, Kelly

Sharon - I am not currently in your situation for I have not yet submitted to my insurance company, but if this does happen to me - nobody is taking this away from me! Not even an insurance company - it is their job to deny claims so they can save money. They are not concerned about your best interest; therefore, I agree with the others - fight for your rights! You obviously have decided this option is for you. Be strong and know that God is on your side! Anita

Sharon - Found this url on this site for a draft appeal letter: http://www.obesityhelp.com/morbidobesity/m-instrouble.phtml Best of luck! Anita

Sharon I sympathize with your problem. I wanted to have the surgery two years ago. My PCP - who I adore but he can certainly be like a little Jewish Momma-said "no" and got me on a diet which did work - I lost 75 lbs. Then, AS USUAL, I went off the diet and regained all the weight plus some. We tried another diet. I tried Accupuncture (VERY interesting but didnt work!) Finally after two years - and at my heaviest ever, Doc said "ok" to surgery. I immediately went nuts, trying to find surgeons, etc. I need that letter of medical necessity the insurance companies want. My doctors first was lame.....sort of dashed off in a hurry. I nagged him to try again. He did. His letter basically said that I had very successfullyu lost weight over and over and then gained back every pound, including 50 extra .He outlined all co-morbidities. He stated in a strong way that my only hope at this point is to have surgery. THIS letter worked.........July 18 is my day. Let me know whats going on with you......Im rooting for ya!!!!!! Miss Ann