Denied (Again)

Well, I got my letter back from the insurance company today and my appeal was denied.  Here are some of the details from the letter:

"Over Grievance and Appeal medical director, a pediatric critical care physican, Victor N. Blankson, MD KY license # . . . .  in conjunction with an external independent reviewer specializing in general surgery and bariatric surgery, Julie Kim, MD, Mass. license # .... thoroughly reviewed the following information:  written appeal request, notificaiton of denial issued by Active Health Management, Active Health Management criteria, medical records from Centennial Bariatrics.

We were unable to approve the requested bariatric surgery revision on October 4, 2010 because there are not any documented complications of the Laparoscopic Gastric Banding procedure performed in 2009.   . . .As a result you do not meet plan criteria for revision or repeat bariatric surgery, from the Laparoscopic Gastric Banding to the Duodenal Switch, at this time."

So, any suggestions on what to write in my request for the Independent External Review?

Also, I am going to call somebody, either my PCP , or find a GI doc and see about getting an upper GI done.  

i would definitely get my surgeon to perform upper GI as it seems from their letter they need proof other than inadequate weight loss of problems.  i actually told my surgeon we needed to do that before we submitted for revsion (i had vbg) and he declined;  guess what.. i got declined (after they approved me verbally).  good luck!