Need help with revision appeal process

My insurance has denied a revision for rny. The reason it is needed is due to history of ulcers, (had emergency surgery for a perforated ulcer, 2 years ago.I continue to experience extreme abdominal pain on a daily basis. I take 160mg of Prilosec daily and Carafate 3 times daily. I can't even remember all the other meds the Dr. has prescribed, but nothing is helping. Just had surgery on April 1, they thought I had an internal hernia, it turns out that the limb was left only 35cm long, (about 1/2 the length that is should have been apparently!) And that is causing everything I eat and drink to reflux back up into my pouch, causing horrific pain.  So, now I am seeking some help in writing an appeal letter to my insurance to overturn this denial. If anyone has sample letters or any advice, I would appreciate it. My original RNY was December of 2002. I lost a total of 110 pounds, and have gained back about 35.  swoods62

I would invest in hiring Gary Viscio to do your appeal.  I hired him for my original surgery appeals, it was the best $ I spent.  Get all copies of your records ready and a copy of your plan descriptions and contact his office.  He has a very good approval rating.  You can look at the insurance forum and see a post he did that talks about what insurance companies are looking for in revisions.  It is a very intersting article.  I hope that I can get my revision approved, but I won't hesitate to hire him again.  Best of luck to you. Deanne

Hi, what was the reason YOUR ins gave for the deniel? Exact words please.  May have something for you. Name the insurance carrier and what is the appeal process?  How many days to responsed and when was it denied?