Denial - Experimental

I found out Friday that I was denied by Independent BC/BS of PA for my DS due to experimental/investigational. I was so happy before seeing the surgeon because I had read on this site that it had come off the investigational list. And boom here I get the denial, come to find out it was a different BC/BS that was approving and it had come off their investigational list. I just don't understand. I'm going to appeal but I don't even know where to begin. I've been searching for as much information as I can find. I've seen some others get approval but after months and months and final appeals and even hiring lawyers. I just don't have that type of money and I know in my heart that the RNY will not be a good surgery type for me for numerous reasons. Has anyone had any luck with this insurance company, did they just deny me the first time to try and scare me? Any information would be greatly appreciated. Thank you in advance! Elizabeth

I wish I could help you, but I don't know much about the DS. (I had RNY 10 months ago, and for me, it was the best decision I've ever made.) I would think that even if DS is on their experimental internal list, that you could find enough documentation to support that it isn't experimental at all, and should be approved. I know someone who is in Brazil, self paying for a ds right now, as she was uninsured. It's pretty cheap down there. Personally, I would take whatever I could get paid for, RNY or lap is better than being morbidly obese. Of course, I respect your decision to choose what is best for you. Keep your chins up! Roberta