Questions about my appeal letter......
Ok, as most of you have read, i got the dreaded "denied" 3 weeks ago. I am about to file my appeal, and have gotten my letter, the letter from my pulmonologist (sleep study was negative for sleep apnea, but dx'd me with "excessive daytime sleepiness"), and should get the letter from my pcp tomorrow.
HERE'S the question... Anyone out there with any recommendations on facts or anything else to use, or things you used in your appeal would be very helpful. I am NOT asking for your letter or info, as I have all of that....don't want anyone thinking the wrong thing here... Just any suggestions of things i haven't thought about that may help me with my appeal.
Thanks AMOS folks!!
April,
Have you ever seen a psychologist or counselor over the years?
I had a doc that I saw years ago write a letter for me and we included that in the info my surgeon sent with his letter.
And I was approved.
Have you contacted the insurance company to find out exactly why they denied you? what was the verbage used?
Could it just be that you need 6 months of supervised weight loss?
Don't give up!!!!!!!
Rhoda
Thanks for the post and support... Ok, hope I don't get too long winded here....
No, never saw a couselor or psych until I had my psych exam in oct.
I had 7 months of documented weigh****chers, where I lost a WHOPPING total of 15 lbs. I have put on 13 of this, too, by the way. There reason was that that was not a "failed" diet. Of course, I have found some things from the NIH that states some facts, and other sites, so, I'm disputting that first off.
Since my first appeal, I also have a new pcp who is in FULL support of the surgery (my old pcp was 90 lbs and said "it is easy to lose weight") and told me this surgery was the "easy way out"...umm...no, it's NOT.
Also, I had a sleep study due to chronic fatigue and other sleep apnea symptoms. Test was negative for sleep apnea, but I do have "excessive daytime sleepiness" as an official diagnosis.
I feel I have done everything and jumped through all their rings of fire.. and am just hoping someone will read this and think "she needs to do this too...."
Thanks to all of you for your support!! It's great!! Happy Holidays to all, too!!