Please help with appeal letter

Hi everyone, I just got denied and I am so sad and disappointed! I got an approval letter about a month ago, turns out, it is an approval for the "hospital" stay and not the actual surgery!! I have blue choice advantage. Now I need to appeal, how is that done? When I was talking to the insurance company on one line, I was talking with the Dr's office on another line, and she was telling me the Dr was in surgery as we speak doing a lapband and the insurance was paying for it!! She also said that she could come up with 6 names off the top of her head they paid for!! Although one was with a lawyer and the insurance lost and had to pay all including court costs. Can anyone help me to know how to appeal? Thank you Karen

Karen, The first thing you should do is find out why you were not approved for the surgery. Often it is because you do not have enough of a diet history. If that is the case, you can give the insurance company more information or do a supervised diet. Your surgeon's office should be able to help you with this. There are lawyers that help with appeals for wls. I used Gary Viscio (http://www.obesitylawyers.com/ ) before my information was submitted to the insurance company because I wanted as stong a case as possible. There is another lawyer whose name I can't think of off hand (he advertises on OH, so you should be able to find the name). Best of luck on your appeal. Mary 302/188/1??

Mary S.- The insurance said they don't cover it because it is experimental.Isn't that crazy. He was performing one as I was on the phone to both insurance and the Dr's office!! And my insurance covered it!!!! Are Blue Choices all the same?? Thanks