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What do I do now? Obesity lawyer? Appeals advocate? HELP!!

stormy D.
on 2/10/09 11:47 am, edited 2/10/09 11:47 am - spring hill, FL
My initial submission for approval to have the DS was denied. There was a peer to peer review today and the decision stands. I was denied by my Cigna PPO insurance because the surgery was considered "experimental" for my BMI. They do cover DS but only for BMI >50. Medical necessity has already been proven because I was already approved for the RNY. The BMI under 50 is my only hang up. I would like to hear from anyone who has used a lawyer or appeals specialist. Also a name and contact information if you were pleased. I would really love to hear advice as to how I should proceed to ensure my greatest chance of success. Diana Cox?  I will pay the fee to obesitylaw.com tomorrow if I could just hear from anyone that has been able to prevail in a case like this. I spoke to Kelly at obesitylaw.com today.  I asked if she were successful in a case like this before. She said she hasn't had many of these cases and never answered my question. Please, any advice or guidance would be so greatly appreciated.

Yesterday is history,Tomorrow is a mystery, Today is a gift
That is why it is called the present.

 


 

        
joslim
on 2/10/09 4:04 pm - NV
AWWW i am sorry to hear that!!! that sucks!!!  you know my feelings on this, just let  me know and i'll start cooking.  i get the feeling we are both going to be stuck. i am not sure what i am going to do about gagner if he doesn't take my insurance once he goes back to ny.
Vicki Browning
on 2/22/09 2:54 pm - IN
Diana Cox is your best person to work with and get help from her  she is the best
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