Help with Appeal Letter
Hi there...I'm trying to helping a friend who has been denied twice in having the surgery. She has followed through with all requested tests however the nutritionist is on the outs with the doctor and she somehow has taken it out on this patient and has written negative things about her (don't know how) and because of that nutritionist the patient has been denied twice. She has Cigna - and if you have it - you know what I'm talking about. So I want to help (she doesn't know the English to well) so I'm looking to get some letters to see if we can draft something up. If this doesn't work then hopefully we can try a different doctor. Your help is appreciated.
Ruth,
I know a great nutritionist who is very supportive of the surgery. Her name is Karen Beerbower. Can your friend go to another nutritionist?
Has she looked into www.obesitylaw.com, the lawyers there have a good success rate of getting people approved.
I have Cigna and was denied twice, once on the first request and once after a peer to peer review where my GP called Cigna's doctors. Once I did everything they asked I was approved pretty quickly.
I never had to write an appeal letter however I did have my life story as a fat person in my file. If she hasn't done that I'd encourage her to do so.
Good luck, you're a good friend,
Rhonda
Hi not sure if this will hel*****t but take a look at Sharon Brittain's profiles, she wrote an excellent letter to get approved, which might help. Its also a great profile to read anyway. Another to look at is Sharon Neva's profile. Not sure if they have any copies of appeal letters on this site but you might check gastricbypassfamily.com also. please keep us posted and good luck to your friend.
Tammy
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