I got word

I got a call this afternoon from Crystal.  Denied. I still don't know why.  They are supposed to fax the denial letter to her by Friday and that should give specifics.  In the meantime, she asked me to work on an appeal letter which is what I've been doing all afternoon and evening. She wants me to have the appeal letter to her by Friday, so hopefully when she finds out why they denied me she can fax it along with whatever else they think they need. I'm not gonna lie, I'm bummed, but really, I expected a denial.  I don't know why, I just felt it in my heart.  I'm really glad though to have heard SOMETHING even though it wasn't what I WANTED to hear! Now, I have a question...  What do you think is more effective?  A short and to the point letter detailing my problems...  Or something long and drawn out like the sample here on this site?? Any input is GREATLY appreciated! Thanks to everyone for your continued support. Dot

I'd go for a letter that documents and details all of your co-morbid conditions. I'd include any pertinent physician visit documentation, lab tests, etc. I'd make it as specific and informative as possible. I'm sorry you were denied, but I'm so glad you're appealing. I'm got my hopes up for you! What insurance company are you dealing with? I hope you get approved very soon!     Shelly

The letter I have so far is loosely modeled off of the sample here at OH.  I think at OH it is called "pre-approval" letter though.  Anyway, It is long enough...  I might post it here for you all to proofread and help me with. My insurance is Preferred Community Choice. Thanks

Dot, Oh man!  I am so bummed too!  I used the letter here on OH as a guide.  My laeeter was 2 pages long.  Make sure they know how much you have tried to lose weight and the co-morbidities it is causing.  Let me know if there is anything I can help with! Michelle

OMG!  lol  My letter is 4 pages long!  Do you still have a copy of your letter you send me??  The first page is a bunch of info stuff though like address, return address, policy number, group number, date, etc...  And the last page is only really about 5 lines long and then my salutation.

Dot,    You are the WOMAN sug! You have been so diligent and on top of this even though it sounds like NO ONE else has been. I am so proud of you for keep on keeping on. Heck yeah start getting that letter ready! I'd ask that same question you posed here to the woman around this site that used to deal with insurance people (or still does). If you don't know who I am talking about I can look up her info for you. Keep at them until they finally give up trying to get rid of you and just say whatever she wants, GIVE IT TO HER! Anyway, if you need to vent to anyone pm me and I'll give you my number. Or, if you need a shoulder to cry on, I've got that too. Hugs~Joni

I think I know who you are talking about...  Are you talking about the one who QUEENBEE contacted?  I never thought of that.  Thanks for the idea! I'm actually taking this quite well since it is really what I expected...  I'm hoping things will be different next time.  THAT'S when I'll be bawling my head off! Thanks! Dot

Hi Dot So sorry to hear the bad news but don't give up! Keep trying until insurance approves it.   Please, contact Vicki, she is the lady who help Queenbee wiht her appeal letter. Her profile is at: http://www.obesityhelp.com/member/cutiedoll58/  You have a great attitude, keep your faith that it will happen soon and be very positive! Wishing the best for you Lis

good luck dot your in my prayers

Thanks, Sherrie!  Now, if you can get your doctors office on the ball, maybe we can be surgery buddies? Hope you hear some good news soon!