DS Investigational
hey 'trace 
here's a link to the self described insurance guru (vicky). good luck!
http://www.obesityhelp.com/forums/insurance/3948260/I-am-a-go-to-person-with-Insurance-Problems/
here's a link to the self described insurance guru (vicky). good luck!
http://www.obesityhelp.com/forums/insurance/3948260/I-am-a-go-to-person-with-Insurance-Problems/
be happy, laughter burns calories
You can appeal and win, but you must be meticulous in documenting their reasons for denial are invalid in relation to your cir****tances. Your first level of appeal is with the insurer and the second with your state insurance dept if necessary. I've both won and lost on appeal but the loss was because I left it in the hands of an expensive attorney. I've won when I handled it myself.
Post and see if you can find someone who has won on appeal with your insurer, and is willing to share their documentation strategy, format, language etc. It will be time consuming and nerve wracking.
On the plus side, the fact that 'investigational' was the reason may mean you meet qualifications but they want a way out. At the state level, it will be reviwed in relation to whether this is or is not an established treatment for your condition. That weighs in your favor should you loose the first level of appeal.
Good luck to you.
Post and see if you can find someone who has won on appeal with your insurer, and is willing to share their documentation strategy, format, language etc. It will be time consuming and nerve wracking.
On the plus side, the fact that 'investigational' was the reason may mean you meet qualifications but they want a way out. At the state level, it will be reviwed in relation to whether this is or is not an established treatment for your condition. That weighs in your favor should you loose the first level of appeal.
Good luck to you.
MSW Roux-En-Y Gastric Bypass: Eat sensibly & enjoy moderation
Links: Are you a compulsive eater? for help OA meets on-line Keep Coming Back, One Day At a Time Overeaters Anonymous
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