BCBSNJ denied appeal now what?

ok got first denial then did appeal and now denied again after 54 pages sent to them and they said a surgeon reviewed.

I want sleeve..  I am paying for this insurance under Cobra just so I can do this and only have till end of Dec unless hubby gets new job soon. (i hope)

they said there is no second appeal that I have exhausted all options and have to go to employer? for anything further.... I live in Washington state... so now what can I do.  ready to appeal to whoever I have to.  appreciate any info..

http://www.horizon-bcbsnj.com/providers/forms/download.html

I don't know if this is your insurance but if it is there is a stage 2 and 3 appeal process. I would call the insurance company and ask for appeals process documentation