Starting the appeals process

(deactivated member)
on 7/14/08 12:21 am - NC

Can anyone help me with an appeal. I have found several examples online but could anyone email me a copy of one that worked for them. I have BCBSNC state health insurance and I was denied for gastric bypass, I need all the help I can get. Please help if you can.

Melissa_in_NC
on 7/14/08 12:41 am - SIMPSON, NC

hey

i was just curious if you had received your denial letter. i cant imagine why you werent approved based on your history.

 

(deactivated member)
on 7/14/08 1:07 am - NC

I just posted a Blog on my profile page about what the letter said, you can read it and that will answer your question. Thanks for the reply.

shaunab68
on 7/14/08 1:15 am - Black Mountain, NC

Though I am new at this and can't offer any advice, I just wanted to say how sorry I am that you are having to go through an appeal but how glad I am that you aren't giving up.  My thoughts are with you and look forward to hearing a positive outcome soon!  Good luck!

Jennifer K.
on 7/14/08 3:16 am - Phoenix , AZ

I suggest appealing the reasons why they denied you - I wouldnt necessarily use a 'form' letter. When my insurance denied be for a, b and c, I appealed why a, b, and c wasnt correct and why I did in fact meet the criteria.

First visit to surgeon - 288 ~ bmi 45.1
2 week pre-op 252 ~ bmi 39.5
Total lost - 153 Since surgery - 117!
Goal weight - 155 (mine) 180 (surgeons)
Current weight - 135 (2020 I lost 10lbs due to dedicating myself to working out more and being in better shape)

1/14/2025 still maintaining 135 :-)

Extended TT, lipo, fat injections - 11/2011

BA/BL/Arm Lift - 7/2014

Scar revision on arms - 3/2015

HALO laser on arms/neck 9/2016

Thigh Lift 10/2020

Thigh Lift revision 10/2021

MyOMy
on 7/14/08 7:27 am - Youngsville, NC

Stick to the FACTs and DOCUMENTATION. They have specific guidelines that must be met. Find all of the medical records that you can that relate to your denial and...send them. Let them know that you do IN FACT meet the guidelines.

Best Wishes!

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