I need help, please!!!

sheilagirl98
on 5/7/08 1:32 am - Portland, TX
I sent my paperwork to my doctor in November 2007.  They called my insurance to verify benefits and was told that as long as it was medically necessary they would cover my surgery.  I have 5 years verifible bmi of 40+ , i have sleep apnea, diabetes, and high blood pressure so my doctors office sent my paperwork in for approval.  I was denied.  they said there was an exclusion in my policy.  We then both sent in an appeal and was denied again. they said that they saw where someone called in Nov, but that they didn't have the conversation on tape but that they did have it on tape where after it was denied they told us there was an exclusion.  How convient that they don't have the one where benefits were verified but only the ones where they say there is an exclusion.  Does anyone know what I should do now?  Any help would be greatly appreciated!!!!
knittermom
on 5/7/08 4:47 am, edited 5/7/08 4:47 am - Sacramento, CA
Sheilagirl98 - take a look at the Obesity Law website.  You will have to Google it since the PTB won't let us post websites in the normal way!  They have great letters and much information on how to appeal.  Good Luck!

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(deactivated member)
on 5/7/08 4:50 am
robyn_fresh
on 5/7/08 9:16 am
RNY on 12/18/12
By the way Shiela I think you're a beautiful lady!
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