Appeal!! they are going to do a peer review?? Does this work
I have BCBS of Minnesota. My doctor submitted for approval then I was denied. I wrote an appeal letter with doctor visit notes and dates and copies of what they had written all were noting the soars and rashes. That appeal was returned denied also and with this appeal they sent me information to do an out of office appeal to the state. I have everything addressed in my letter as what they require to have the surgery but was denied. I have now called and asked for a peer to peer review with my doctor and they are lining it up. Is this a good sign, has anyone gone through a peer to peer review?? Should I still be hopeful?
On March 21, 2011 at 10:51 AM Pacific Time, Joe_C wrote:
I have BCBS of Minnesota. My doctor submitted for approval then I was denied. I wrote an appeal letter with doctor visit notes and dates and copies of what they had written all were noting the soars and rashes. That appeal was returned denied also and with this appeal they sent me information to do an out of office appeal to the state. I have everything addressed in my letter as what they require to have the surgery but was denied. I have now called and asked for a peer to peer review with my doctor and they are lining it up. Is this a good sign, has anyone gone through a peer to peer review?? Should I still be hopeful?HW 341/SW 309/CW 169/GW 190 172 lb. loss with my DS - Subscribe to me on YouTube!
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Thanks, I will check it out. I plan on apealing for ever, but maybe I will have my doctor just ask for the panny and upper chest if I keep getting denied. I have doctor visits and prescriptions for everything that they require prior to surgery so my doctor and I don't understand what I am missing. So I am quite confident that I will get something done.