Denied for Exclusion

For anyone who is keeping track of me....Unicare denied my pre-determination on the basis of exclusion. I have no intention of letting it rest!!!! Thier letter said to call if I had any questions and of course, I did. The lovely woman who answered the phone could not seem to tell me who actually sent the letter, but she tried to ansewer all my questions. First off, she said that they NEVER pay for WLS as it is considered strictly "cosmetic". We talked about the difference between cosmetic and medically necessary. I asked if they had read the 70 pages of supporting documentation including letters from 3 PCPs and the surgeon showing the medical necessity of this procedure. She said that she did not know.... Then went back to how they won't pay for anything with a diagnosis of OBESTITY. I asked her if they would pay if we changed the diagnosis to any or all of the co-morbities, and she switched gears and said it was NOT a COVERED procedure NO MATTER WHAT. After some more conversation where she was as helpful as she could be, she wound up telling me that several people RIGHT THERE IN THE UNICARE OFFICE have had the surgery and are ever-so-much healthier and happier. How it eliminated their high blood pressure, high cholesterol, muscular-skeletal problems, diabetes, sleep apnea, etc.... WAIT AMINUTE------- Do the people that work for Unicare carry Unicare insurance?????? The answer: (get this.....) is "Well yes, they have Unicare insurance, but they have a "Large Group" policy, and your company carries a "small group" policy (9 employees). Weight reduction services and treatment are an exclusion only for small groups!!!!!!! I am pretty sure there is a very win-able fight here....I just need to figure out how to go about it correctly. Thanks for listening! And of course, any and all suggestions are welcome!