Insurance Appeal Question
Today I recieved a letter in the mail responding to my appeal letter. With my insurance there is a direct exclusion policy for surgery for morbid obesity. I appealed the denial asking for them to approve to cure my other conditions with this surgery being a means to do that. They responded with saying that they are giving me the opportunity to meet with the appeals committee. Is this standard procedure or does this mean that they may actually be considering it? I hope so. I'm a little nervous though to meet with the committee as I don't look over 100 pounds overweight. I hide it well, but am definately there and I feel it everyday, every hour, every minute if you know what I mean. Has anyone had to meet with an appeals committee before and if so, what did they do in the meeting?
It can only be a good think but I wouldn't read too much into it other than you have a shot at it. That being said, do your homework. List all co-morbitities and emplasis what statistics that show wls can help and or eliminat the problems. Take handouts for each committee member with a few extra just in case.
If you do not look like you are 100 pounds over weight I would mention this just like you did here and then talk about the issues.
Good luck.
Jim Randall