PS denied by GHI . How do I appeal. Pls help
I just got denied today for panni removal. I had letters from the bariatric surgeon, my PCP and gynaecologist. I however did not submit any documentation of rashes of pics of rashes.
I think I have seen my PCP 4 times in one and half year for rashes and they gave me cream for it but no pics were taken .
Can you guys please advise me what to do now. The reason for denial is that I did not have any rashes documents and pics submitted to the insurance. I was told I can appeal the decision but i need to know how to progress from here and what to get now so I can appeal it and have it approved.
Any info will be greatly appreciated.
Thanks
I think I have seen my PCP 4 times in one and half year for rashes and they gave me cream for it but no pics were taken .
Can you guys please advise me what to do now. The reason for denial is that I did not have any rashes documents and pics submitted to the insurance. I was told I can appeal the decision but i need to know how to progress from here and what to get now so I can appeal it and have it approved.
Any info will be greatly appreciated.
Thanks
Ok, you should appeal as soon as possible and please include all documentation you have for rashes.This is very important to cover panni removal.and you will need to submit receipt from pharmacy to prove you got prescription treatment cream for rashes.
good lucjk,
alla
good lucjk,
alla
PART 1 VSG 03/28/2006; PART 2 DS 01/31/20007
Even without the pictures, you might be OK. Explain to them in your appeal letter that while you only visited the Dr occassionally for the rashes, you deal with them costantly on a day-to-day basis and only visited the doctors when it got so back that the over the counter stuff didn't work. Let them know that you have to powder the area frequently, buy OTC creams and powder.
Also, did the Dr's you visited actually put the diagnosis code for a rash on the claim? I had a doctor visit where they put it in the notes and not on the code and the insurance wouldn't look at it on my appeal.
Also, did the Dr's you visited actually put the diagnosis code for a rash on the claim? I had a doctor visit where they put it in the notes and not on the code and the insurance wouldn't look at it on my appeal.
RNY - 12/10/2008 Dr. Terive Duperier of BMI of Texas
Lower Body Lift / Breast Lift - 07/20/2011 Dr Peter Fisher of San Antonio Plastic Surgery Center
Lower Body Lift / Breast Lift - 07/20/2011 Dr Peter Fisher of San Antonio Plastic Surgery Center