State Of Wisconsin Insurance appeal

Has anyone had to appeal to the State of Wisconsin employee trust? I had my appeal yesterday with Mercy care and they denied me again. Now I have go through with another appeal with the state. Getting tired of all the BS, I contacted the New York lawyer that everyone talks about on this site. He is a really nice guy to talk to and says he can help me out with the issues that I have with the Ins.co. Any info would be a great help to me. Thanks

Have you looked at the Independent Review Board process through the Wisconsin Insurance Commissioner?? I believe you have to exhaust the appeal process with the insurance company and then you can request an Independent Review. The options are explained on the website for the WI Office of Insurance Commissioner. Do a web search for their site and once you are on their site, do another search on their website for Independent Review and the explanation should be available. If you have trouble finding this, please let me know, I will find it for you, but I'm on my way out right now and don't have time. . . . Good luck!!

Hi Stacey...I hate to sound negative, but we called the State Insurance Commissioner last summer because we were fighting with Dean Care ins. because of a denial. The Commissioner told us flat out that if it is an exclusion, there is nothing they can do for us. The State of Wisconsin does not require insurance carriers to offer coverage for the surgical treatment of morbid obesity. Just to be safe though, I would contact them again just for peace of mind. Hope this helps...Ken

Hi Jim, I live in Sauk City, WI and have Physicians Plus and I know that both Dean and Physician Plus basically refuse to cover any surgeries. I finally decided it was just to much trouble and I am now self pay. It will cost me a package deal of $18,000. That is for my evals, dietician visits, 24 hour hospital stay, anestetic (God I wish I had spell check here), operating room, recovery room, and to visits after. The doctor is separate. I just can't wait any longer to have this surgery. I need to get going and start working out over the summer months. My surgery should be the second week of May. Can't wait!