HELP! 2nd appeal for Boeing Regence Traditional Medical Plan BCBS

Donna Childress
on 4/14/09 4:15 am - Maple Valley, WA

Hi,

I'm working on my second appeal for my RNY surgery. Have to have it all turned in by this Friday. My insurance is Boeing Regence Traditional Medical Plan that is through Blue Cross/Blue Shield.

Insurance claimed that I had not successfully completed the 6 months dieting through an MD with weight loss/no further gains.

I have now had 6 months of monthly weigh in's with my family physician, but am worried to death that it still might not be documented enough in my MD's chart notes.  I also did Weigh****chers on line with E Tools.

My question is:  Does anyone know of "great" verbage/language to use in my appeal letter, any great statements, any wonderful resources to state to support weight loss surgery to use in my letter?  I feel the more information I can supply the less chance I have of them turning me down again.  Even if you have a different insurance any advice is greatly appreciated. 

If anyone has the same insurance as me - could you let me specifically know what you submitted - it sure would be deeply appreciated.  I have called my insurance representative and insurance company numerous times and have copies of insurance requirements.  The wording is so "sketchy!"  I can never get any straight answers from them as to exactly what I need - it's very frustrating.

Thank you,

ragadolly in Washington State

 

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