Seeking Possible Legal Help for a Revision

lalala2
on 1/5/09 3:04 pm - Winnetka, CA

In case I get denied for my revision surgery, I want to be prepared.  Anyone out there know anyone who assists gastric bypass patients get approved once denied?

hollykim
on 1/11/09 10:56 am - Nashville, TN
Revision on 03/18/15
I have been appealing my insurance exclusion with the legal aid of Walter and Kelley lindstrom at www.obesitylaw.com and have been very pleased. We are waiting to hear the results of the first appeal. Good luck!
Holly

 


          

 

lalala2
on 1/12/09 12:38 am - Winnetka, CA
Thanks for the info Holly.  I wish U every success.  Please PM your outcome.  By the way,I have family in Clarksville, TN (I live in Los Angeles).  It is a small world!  
 
(deactivated member)
on 1/12/09 4:13 pm - sunny, CA
 Do you have a HMO or PPO?  Is your insurance also out of CA? If  you have a HMO then the DMHC (dept of managed health care) may be able to help you. If you have a PPO then you can contact the dept. of insurance (I think that's what it's called).   They oversee insurance companies. 

Does  your insurance cover WLS, do they have an exclusion? If you meet NIH criteria for WLS you should be able to get a revision. Make sure you exhaust all your appeals through your insurance and once you've done that, depending on the reason for your denial, you may be able to ask for an IMR (independent medical review) with the DMHC or file a grievance with them.
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