HELP!! "INVESTIGATIONAL" DENIAL FOR VSG

kourichavez
on 1/22/10 2:38 am, edited 1/22/10 2:40 am - Tigard, OR
Okay I received my first denial for VSG, does anyone have any sample letters or words of wisdome for my appeal?  I am not very good on the phone as I tend to get emotional and lose my train of thought or have difficulty speaking due to my frustration, so I prefer to write a letter.  Any help would be greatly appreciated, as I want this surgery really bad.
                
Stephanie C.
on 1/24/10 4:31 am - Chicago, IL
Theresa included a copy of her appeal letter in her blog (see link below):

http://thediaryofafatwoman.blogspot.com/2008/11/deny-deny-deny.html

She was able to overturn her appeal.

Hope this helps!

-Sam



You see things; and you say 'Why?' 
But I dream things that never were; and I say 'Why not?'

- George Bernard Shaw
(deactivated member)
on 2/7/10 7:17 am - AZ
On January 22, 2010 at 10:38 AM Pacific Time, kourichavez wrote:
Okay I received my first denial for VSG, does anyone have any sample letters or words of wisdome for my appeal?  I am not very good on the phone as I tend to get emotional and lose my train of thought or have difficulty speaking due to my frustration, so I prefer to write a letter.  Any help would be greatly appreciated, as I want this surgery really bad.

If you have WLS benefits and if you meet the criteria your chance for approval is pretty darn good especially after 1/1/10.  Medicare now recognizes VSG and they have a code for it.  Most ins co's follow the same trends as Medicare.

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