Denied! Horizon BCBS of NJ
Horizon BCBS of NJ has denied my request for VSG. They believe it to be experimental. I knew this and plan to appeal, but I have a question.
Why do some BCBS plans cover the VSG and others do not? Either BCBS considers it experimental or they don't. Can I use this argument as part of my appeal? Also, I do know of at least one instance where Horizon BCBS of NJ covered the VSG. How do I include this in my appeal? Do I have to name names? Any advice or info is appreciated!
Thanks!
Leah
Why do some BCBS plans cover the VSG and others do not? Either BCBS considers it experimental or they don't. Can I use this argument as part of my appeal? Also, I do know of at least one instance where Horizon BCBS of NJ covered the VSG. How do I include this in my appeal? Do I have to name names? Any advice or info is appreciated!
Thanks!
Leah
20.5 lost pre-op. highest/pre-op/current/goal 283/262.5/151.5/155
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