NEED REVISION APPEAL LETTER

JUST FOUND OUT I WAS DENIED FOR THE REVISION FROM VBG TO RNY. NOT REAL SURE OF THE DETIALS BUT I DO PLAN ON APPEALING IT. ANY HELP WOULD BE APPRECIATED. THANKS, AMY

Who is your carrier, Isn't there a copy of appeal letters on site somewhere. Have you considered an attorney. Ther is a site for them. [email protected]

Amy, call your insurance company and ask them specifically what they need to approve this surgery. I was initially denied for lack of medical necessity. Then I was diagnosed with high blood pressure, so I asked my PCP for a letter of support for my revision. Although my weight is only 215, I have gained back half the weight I lost with the VBG after only 3 years and very committed exercising. I wrote my own letter of appeal stating all of these facts, as well as a few others and also with the letter of support from my pcp. I won my appeal and my revision is scheduled for Feb. 11th! My advice to you is get a letter of support from your pcp. If you have any co-morbidities, have her put them in the letter! Good luck and keep me posted. Dori

Hi, I'm in the process of getting approved. The surgeon suggested I get as many letters as possible to send with the approval request. Only got my PCP to write. She wrote an excellent letter outlining all my medical problems. There are many. My starting weight was 355. I lost 165 but gained some back. I am not at 220 and going up. My stoma stretched.