2nd Level Appeal letter Help!

Jen B.
on 6/30/04 6:48 am - OH
Hello, Wanted to see if anyone out there has a copy of their letter for a 2nd level appeal that I could look at that was used in a second level appeal. I am being denied due to not having a physician-supervised diet & the fact that mu BMI fell below the 40 mark twice in 5 years. Thanks to anyone who can help! Jen
mekoh66
on 7/2/04 3:11 am - Toledo, OH
Jen I was denied the first round for basically the same thing. Because I didn't include any records from a physician-supervised diet within the last 2yrs for at least 6 months and 3 months had to be consecutive. So when I sent in my appeal I was able to include weigh-records from 2 programs that I had attempted. The records showed what my beginning weight was and then showed the dates and the weight for each time I weighed in. I also had my PCP write a letter stating that he knew about my attempts on these programs and that he supported me on these attempts. He didn't feel that constant office visits were needed because the programs had the tools to do so. The only reason that I needed to see him was if I started having medical problems. My records from the diet centers covered the time span the insurance company was looking for so I just asked them to reconsidered their decision based on the previous records they had already plus the new reocrds I sent them with the appeal. I hope this helps! Heather
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