PLEASE HELP STATE APPEAL HEARING SET (AHCA)
Hi everyone,
I really need help from anyone that has been before the AHCA state appeal panel. I am scheduled for 12/6/04. They told me I have 15 minutes. I don't even know how to prepare for this. WHat should I say? They have the enire file & pictures. (this is for my abdominoplasty & thigh lift denial.) PLEASE HELP!!!!!
here are two letters i did for my appeal. maybe something in here will help you . good luck.
HERE ARE TWO LETTERS I SENT TO MY INSURANCE VIA DR BADDOURA OFFICE. THE LAST LETTER IS THE FIRST ONE I SENT.
JULY 1,2004 THIS IS THE FIRST LETTER I DID
To: Medical review board
Dear Sir/Madam:
First I would like to say that my success of the Gastric Bypass surgery has changed my life and health issues to such an extreme, I cannot be thankful enough for this life saving surgery.
I have lost 107lbs and as you know, losing that much weight in such a short time period has had unbelievable changes to my body as a whole. I have worked out on my own at home and at a gym when I can find the time to get there. I have two beautiful daughters and a caring and supportive husband, which is very time consuming in itself.
But now, I am in need of assistance for removal of the excess skin I have all over my body. The rashes I get in the folds of my skin that overlap my body, are unbearable. I've tried everything I can possibly do; powder, salves creams and nothing seems to help. Now with the summer coming and with the heat and humidity that the Florida weather can bring, I'm very concerned with these rashes becoming more severe and am afraid of infections, that could lead to expensive medical treatments.
I am requesting that the skin be removed to help with the painful skin rashes and irritations I am getting. I've tried toning up but, it is apparent that my skin elasticity has met the point where nothing else can be done, other than another surgical procedure.
I would like you to deeply consider these issues and know that it is something that is a dyer need. I would be so grateful to have the pain relieved and the knowledge that I don't have to worry about infections and rashes after this is completed.
Yours truly,
Consuelo Gonzalez
NATIONAL APPEAL UNIT ( SECOND LETTER )
P.O. BOX 5225
SCRANTON, PA 18505-5225
REF: CONSUELO R GONZALEZ SS# 263-75-1024
Dear Sir/Madam:
I understand that you have denied my physicians request and also it appears my letter to you did not have any impact.
Now it is summer in Florida. The temperature**** in the 100's with the heat index and humidity. I am now having serious complications from rashes and yeast infections. I am consistently in pain and discomfort.
You will fix a broken bone, so it will heal right. You will take care of skin cancer, you will fix a deviated septum due to discomfort and breathing problems; I don't understand what the difference is between those conditions and mine?? I am in discomfort and despair ALL the time. It's even difficult to sleep.
I am willing to be interviewed if you would like. My doctor has even requested this procedure. I do not want to suffer any longer with this, I am depressed and anxious. I fear my mental well being is getting worse as the days go further.
Please reconsider your denial. I would be most grateful. I need this done before it keeps getting worse and worse
ATTACH PLEASE FIND A LETTER FROM ME SENT TO YOU BY DOCTOR OFFICE.
THANK YOU FOR YOUR TIME
SINCERELY,
CONSUELO GONZALEZ