Denied Again. Help!!! Need official Appeal Letter

Hi Guys

So once again I call the insurance and they deny me again for the same reason.  Non compliance with Diet and exercise.  When I ask the lady to please be specific because I don't know what else they want from me.  She tells me that she looked over the paper work and see that one month I was following a 1500 cal and then another month a 1800 cal and then back to 1500.  HUH? So...... This is what my Doctor wrote and advise me to do.  At first she felt like I should should start low but when she realize I was hungry a lot she adjust it to my size and Bmi.  When I then started going to the nutritionist because my Doctor no longer practice she put me on a new and different diet to follow.  I provided them with all the info from the Old Doctor and new doctor and yet its still a problem.  Now I need to appeal and need help on doing so.  I already have the address on where to send my letter too.  I just need to know how to plead my case.  I even went to my gym and got a copy of all the times I went to the gym day by day.  I also spoke to my new nutritionist and she will be sending them all of her notes as well as all of the weekly food diary I kept since I started with her.  Once again I want to just break down and cry but my anger wont let me.  I just don't understand how this health care system works.  I bust my ass and pay them almost a 100 every two weeks for medical and when I now need help they tell me they can't help me.  How dare them. 

I'm so sorry -- frustrating I know --
Since my own situation is a 'no win' one with insurance, I've decided to raid my retirement IRA and pay for my own -- scary on two parts - one using money I've worked hard for for my future -- two, knowing that any extra expenses from complications or just plain 'stuff' will also fall on me -- could ruin me financially -- however, I've decided that I'm still worth it!

Keep fighting!
Hugs,
Nannette

Great Attitude.  You are worth it and you never know what the future holds for you.  God may just bring you back all that money in another way.  I've decided to seek help from some Great DS vets (Dianna Cox and Larra).  Im going to drop all this anger and put this energy into good usage.  This is by far over and like I said in my previous post, I will fight this until the end.  If I have to pay out of pocket in the end result then I will do so but not without a fight. 

I'm so sorry to hear this! These damn insurance companies kill me!  Don't give up and continue fighting, I can't believe that with all the documentation provided they had the nerve to still deny you.

Keep fighting for what you  want and call Gina and see if she can help as well.

Frankie

Thanks Frankie.  As someone told me this is what the insurance do so you can give up but they have another thing coming.  I am by far giving up on this battle of WLS.  I will have my DS one way or the other.  I believe in God and I know he is really throwing me a curve ball with all the bumps in the road but I will get past them. 

Have you taken a step back to get a copy of your policy and se what it covers and what the requirements are? If you haven't you should bc all you're doing is spinning wheels. Pull it and then do what it says. If you have to do a diet before a decision is made DO IT. Roslin's office will help you but you need to know what your insurance policy says, word for word.

Hii Heather

Yes I have pulled my policy and so far have been doing all of this myself with little help from Dr Roslin office.  I am pretty detail, organize and do my research.  I am actually getting some help from D Cox and Larra at this time and hope to regroup and try again.  Thanks for responding and trying to help.  I will take any help I can at this point to get my appoval.  How is that lapband going for you?

 I am very sorry you are going through this.  Have you thought of contacting Walter Lindstrom in California? I had to use him  when I was denied for my first surgery.  He was able to appeal the decision and get it overturned.  It might be worth a shot.

Unfortunately, I had to delete this post due to privacy concerns.