1st appeal denied

Hi All,

I have posted before about being denied and now in 1st appeal. Well today I received the answer to the appeal which was theyupheld denial. They have the line that bariatric surgery is generally considered to be medically necessary when ALL of the following have been meet: there was the list which I'm sure we have all seen. The evaluator stated "This request is being denied specifically because the following criteria wre not met: The letter received from your Middle Country Medical Care physician is not a thorough medical evaluation documenting your suitability and appropriateness for surgery". I have decided to take my 2nd appeal through NYS Dept of Insurance and have look in the groups files and found a pcp letter which I am going to type and give to my pcp and have him sign. If that is the only reason for denial as they say then with the new letter I am hoping to be approved. I know I have to keep on going but it sure is frustrating.