Appeal Letters that Worked???

I have a friend seeking WLS and he has asked me for a copy of my appeal letter (which I cannot find).  If any of you have a letter (or know where I can find some on this site) please PM me or reply to this post.  I would greatly appreciate it.

PS- he lives in TX and has United Healthcare (in case that matters).

Thanks much!
Shelley :)

What was the reason for denial? Someone who is appealing a decision based on BMI/comorbidities won't have a very helpful letter for someone who is appealing a decision based on a procedure being deemed "experimental," for example.

He simply called the insurance company to see if it was a covered benefit and was told they do not cover it.  He was then told he could appeal the decision if he chose.  I suppose he will get a letter in writing to follow up - but as of yet don't believe he has received one.

Thanks for the clarification (that the reason for denial drives the letter content)
Shelley

Hi Shelly-
A great resource that you can refer your friend to is the Obesity Action Coalition. Here is the link:

www.obesityaction.org then click on 'advocacy tools' on the left hand tool bar and then 'insurance'. They have sample appeal letters that are organized by reason for denial.

Best of luck to your friend!
Billie

HI Billie,

Thank you! I will forward the link to him. We all have our fingers crossed this will work.  He did hear that others had received the same initial denial but upon appeal were approved. 

Thanks again!
Shelley

If your friend is going after the sleeve gastrectomy tell her/him not to waste her/his time United health care stopped approving those 6 months ago. So any appeal won't work I know i appealed 2 times and was denied both times but they wouldn't tell me that they quit approving those in hopes i would go away. I resubmitted for lap band and was approved in 2 days.