Denial of Appeal

sbard
on 10/11/06 3:05 am - west brookfield, MA
HI Folks,  I just spoke to UHC and was told that though my appeal had gone through the MEDICAL REVIEW Board there, they have denied my appeal.  I am currently waiting for the actual letter to come to me via mail as they wil not e-mail or fax it to me due to HEPPA regs. Has anyone had any luck in  having their own employer overturn a denial of appeal? Apparently that is my next step. I work for AIG and am insured under the UHC-EPO plan.  Any assitance will be greatly appreciated. Thanks! Sue
Sarahlicious
on 10/11/06 4:45 am - Portsmouth, OH
What was the reason for the original denial?

I have Lipedema and Lymphedema. I also have a passion for Obesity and Health Insurance Advocacy

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sbard
on 10/11/06 4:51 am - west brookfield, MA
original denial was plan exclusion for "Weight Loss Surgery". I appealed on a medical necessity basis- I am diabetic (have been for 18 years) have high blood pressure & high blood pressure. Family history of diabetes (mother dies at 59 from series of diabetes related strokes) and that they had given me the OK in February for this surgery and have paid ALL bills related to this weight loss surgical program since 4/06. I am not sure what the exact wording is on the denial of the appeal as I have not yet received the letter.
(deactivated member)
on 10/11/06 11:48 am
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