Insurance Help

DJ
on 2/19/04 6:02 am - Parsippany, NJ
I need help. I am attempting to write an appeal letter to BC/BS Highmark that considers DR Abkins' Long Limb Gastric Bypass experimental. I am in need of some stats and documents I can enclose to the insurance company proving this procedure not experimental. I have not been able to locate anything that specifically notes the Long Limb procedure. The Dr's office can offer me nothing more than their website. They don't write appeal letters, and have left this task to me. My primary suggested contacting a lawyer to write the letter but that will be more expense(but maybe worth it). Anything or direction anyone can offer would be greatly appreciated. Thanks!
Jim E.
on 2/26/04 1:28 am - Newton, NJ
Unfortunately you are swimming upstream. Is this procedure the only one possible? If your insurance has been approving the more traditional approach,and your doctor suggests it, go that route. If it is expermintal the doctor should foot the bill as you would be the subject of his study. Fat chance of that ever happening. So, consider the procedures that your insurance carrier has been paying for all along. Jim
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