Appeal/Repost

I have BCBS of AZ. Of course I was denied. Seems like everyone has a problem with BCBS from any state. Should I write my own appeal letter, or should I pay the $450 and have obesitylawyers.com write it for me?  If you did write your own letter would you mind sharing it with me? Does anyone have experience with this?  Thanks!

That's awful. Has your doctor written you a letter of appeal?  I have BCBS of Michigan and my surgeon sent them a letter stating exactly why it was impertinant that I have the surgery. I live here, but had my surgery in Michigan because my cousins had used the same surgeon. Dena

My surgeon won't appeal on my behalf.

That is awful. What about your primary doctor?  I have never heard of a surgeon not writting an appeal. I worked in healthcare for many years and never came across that problem.  Dena

You do not state why you were denied.  Please let me know the specifics and I can see what can be done to help you.  .  An appeal should not be too difficult unless you have an exclusion,  do not meet the criteria or are missing information.  I do work for another doctor but can assist you in figuring which way to go with this.  We do appeals for our patients all the time. Let me know how I can help. Jen

I'm no expert in insurance, but everyone I've talked to with BCBS of AZ have had to do some type of supervised pre-surgery 6 month exercise plan.  Usually, you can contact the insurance company directly and find out exactly what their requirements are for approval.  They can change those requirements on the fly, but at least you'll be able to determine if you have a hard "exclusion" on your hands.  Best of luck on your journey! --Dave

Ihave BCBS of CA. I was approved the first time I submitted I don't have much advise regarding the appeal letter but I can say that I read there approval rules carefully and made sure to submit everything they requested when the requested and then some. Good luck 

I have a state of arizona employee insurance with schaller anderson.  If you come across a good appeal letter please pass it along.  Dr. Blackstones office wont assist in an appeal either...

I'm sorry to hear about your being turned down. I'm biting my nails getting down to the wire. In two weeks or less the bariatric center will have enough information to send my application in to BCBS of AZ, and we'll see what they have to say. But I'm curious about your situation... did they say WHY they denied you?  When I contacted BCBS of AZ they said I had to contact the American Health Group (AHG) to get the requirements for WLS, and AHG sent those to me in the mail. They did NOT include anything about a 6-month supervised diet, and so long as my pscyh eval (yesterday) came out okay, I already meet all of the requirements that they sent to me. I worry though about what they are going to say! Good luck with your appeal. At the WLS Seminar with Dr. Villares someone asked about help with the appeal, but they didn't seem to feel it was a part of their job to help once a denial letter was received.