Letter for appeal

CHart6283
on 10/10/08 11:51 am - IL
Does anyone have a sample of a letter that was used in appealing a denial? I'm not sure what to put in mine. I was denied for not having a bmi of >40 for 5 years. I called the insurance today and was told (again) that if you have a bmi of >35 with comorbidities it would be covered. I have 3 of the 4 comorbidities they listed. I want to appeal their denial, but not sure where to start. Thank you in advance for any and all help!
Vicki Browning
on 10/11/08 12:01 pm - IN
Who is your Insurance carrier.  I would like to take a look at their medical policy and I would be glad to assist you with a appeal letter if you can PM with your specifics height weight and age and any problems you have with daily living due to obesity
Sydneyv
on 10/13/08 4:00 am
I'm also interested in some help with an appeal.  I just got denied on Friday (October 10).  I had completed a 6-month trial period of trying to lose weight on my own, weighing in at my Primary Care Physician's office on a regular basis during this time.  I lost no weight, and in fact, gained 12 pounds during this 6-month period.  They have now referred me to have ONE CONSULTATION with a bariatric doctor.  My insurance coverage is with Aetna HMO.  I'm really feeling hopeless right now.
kcarlson0814
on 10/17/08 6:52 am - CA
RNY on 09/10/12
I have Aetna HMO.. why did they deny you?  I'm going through the 6 month program but wanted to see what to avoid... please keep me in the loop.
HW: 300 / Lapband Low: 247 / RNY: 9/10/12          
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