I was denied for the Lapband

What a helacious past 6 months.  Everything has gone so great.  I did my psych eval, nutritionist eval, attended a class-This January I would qualify for the lapband surgery with my BMI being greater than 40 (the last 4 yrs).  I have GERD so badly that at night i sleep w/ pillows behind my back.  Because i havent been "diagnosed" w/ GERD for the last 4 yrs (I was just recently diagnosed) that gave the insurance company the room to deny my surgery.  Im so sad-so depressed.  My doc says to hire an attorney and have them help me draft up an appeal letter....does anybody have any words of encouragement or suggestions at how I can get my insurance to realize that I really do need this surgery?  Thx so much-D

I wish I had some information for you, but I will say don't give up, do the appeal and hang in there.  I'm so sorry they did this to you, I hope you can win your appeal. 

Thx Shelley!  Im going to hang in there-I have to...im so miserable as I am now...my best friend and I went through this process together...she was approved...i was denied.  I am so happy for her-and excited...and sad and depressed...so weird all the feelings that i am having now.  Thx for emailing me..i cant tell you how much this means to me.

I'm so sorry to hear about your insurance denial - that is so disappointing for you...  I know I saw something very recently about writing an excellent appeals letter.  I just don't remember where I saw it - it may have been on a posting here or in a book.  I just checked the couple books I have and can't find it...  I know hiring an attorney can be expensive, but I would suggest that you post something on the main board here asking for suggestions for an appeals letter and you might get some good help.  If I come across the info I saw, I'll definitely send a note your way.  Beat of luck as you fight through all the red tape - it will be worth it in the end... ~Nancy~

Wow...this is the 1st time i have ever posted anything on this site or any site for that matter...people really understand here!!  thx for the words of advice-I will post something for sure!

That's great - I've found the people on this site to be FABULOUS!!  You'll usually get lots of support and suggestions - and then you can take from it what will work for you.  Good luck with all the insurance stuff!! Nancy

I would go the lawyer route, I bet you could get a letter drafted for less than 2 hours of a lawyers time, wake em up and let them know that you mean business. Also I don't know where you work but a lot of bigger companies offer a free hour or 2 of lawyer consultation as part of your benifits. Maybecheck that out? Otherwise just plain old appeal, I see lots of people din't make it the first time around but got approved on the 2nd or 3rd. Keep trying and good luck!!

Jillian-thx so much for the advice....this is so good to hear from other people...and my office does have a lawyer on site...i will have to find out!!  Thx girl.

Did you ask your Dr.s staff if they have a Lawyer they use?  It might be a way to try! Good luck and don't give up!  Merrilou

Whatever you do don't give up, that's just what the insurance companies count on to get out of having to approve the surgery. I was denied twice before I finally got approved. Both times it was because of technicalities that weren't quite how the ins. co wanted things done. Keep at it and be the squeeky wheel that gets the attention. Investigate around the OH website, I'm sure that somewhere there is a board about appeals. Also look up I believe it is called obesitylaw.com. Hang in there and best of luck!!!