BCBSIL PPO Lame Denial

Ok all I got denied, over the phone they said they 6 month Dr Supervised diet was not a very low calorie diet at 1200 calories. I said when you send the denial it will state this correct, yes they told me. So I get the denial letter in the mail last Friday does it state that, no. It states that there was no proof of participation in a 6 month very low calorie diet, as evidenced by my significant lack of weight loss. So another words even though they have the 6 month diet info as they told me they did, it is not enough. Because I did not lose enough weight for them, I only lost 5 pounds, I got denied. How in the world do I fight that?

I would appeal it based on the fact that if they required a specific caloric intake, that should've been specified PRIOR and IN WRITING. Your physician obviously felt that this was an acceptable low calorie diet-- who are they to question that when they are not forthcoming about what they consider "low calorie". They cannot just make stuff up after that is not indicated anywhere in the policy. If your physician is contracted and he/she felt that this was an appropriate low calorie plan for you, then you should both write a letter of appeal disputing their decision.