HELP........

Wanda A.
on 10/1/07 8:26 am - Clover, SC

Hello everyone, I am in desperate need of your help. My doctors office finally submitted my paperwork Thursday. I found out today I was denied because my bmi is over 55

. Currently, my bmi is 64-65. I don't even want to, or need to express my disgust, disappointment, or rage

. I have not rec'd my denial letter yet however, I am preparing for my appeal. While cruising the forums I came across an appeal letter of a member or her friend (I don't recall), it was so thorough, with quotes and references. I'd love to use it as a guideline for my own. If anyone has an appeal letter I can reference I'd greatly appreciate it. I will also xpost this to see if I can get some help.

Our deepest fear is not that we are inadequate.
Our deepest fear is that we are powerful beyond measure.
It is our Light, not our darkness that most frightens us.
We ask ourselves -- Who am I to be brilliant, gorgeous, talented, fabulous?Actually, who are we not to be?
You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people do not feel insecure around you. We were born to manifest the Glory of God that is within us. It is not just in some of us, it is in everyone.
And as we let our light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fears, our presence automatically liberates others.
M Williamson

granny_jo
on 10/1/07 1:26 pm - Crowley, LA

VSG on 11/12/07

Hi Wanda, You can check out Kimberly Frendy's OH account. She has an appeals letter there that is really good. Also www.vsgfaq.com has an appeal letter. Look under resources and then denied by insurance. I'm not sure if either of these are the letters you're looking for, but they should help. Good luck with your appeal. I should near something on mine this week.

Jo

Granny Jo

shaunaph1
on 10/3/07 1:07 pm - Phoenix, AZ

RNY on 09/30/09

I TOO was denied today. I am soooooooooooo upset. I have done EVERYTHING they asked. They stated the reason for denal is not good enough "documented" evidence of a 12 month diet/exercise under doctor supervision. I went every month for a year. I was weighed every month. Then when I asked the cusomer rep about that she replied "no evidence of long term lifstyle changes" NO WHERE in my benefits book does it say I have to be successful at it, it just says 12 months. How can thing denied based on subjectivity? PLEASE let me know of the letter you have. I could use anything at this point. I have a coworker who was denied last year for the same reason and she just gave up. I am not going to. I am doing to file a complaint with the INsurance commissioner, my uion, and fight!! THANKS

Wanda A.
on 10/3/07 3:54 pm - Clover, SC

The information in the above post was very helpful. Good luck with the fight keep me posted. Wanda

moore972003
on 10/5/07 4:43 am - IN

DS on 04/04/08

Hi Wanda!

I'm not sure what kind of insurance you have or what their requirements are, but are you trying to get approved for gastric bypass?

If so, have you ever considered the duodenal switch? My surgeon, Dr. Prachand at University of Chicago, does the DS on people with a bmi of 50 and over. In fact, with a bmi of 50+, that's the surgery they recommend.

Check your insurance and see if they cover it and try researching it to see if it might be for you. My insurance doesn't cover it, but I am appealing their decision right now!

Good luck!!

Mandy ***See my blog for appeal info***

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