What's the process of appeals for Panniculectomy? United HealthCare POS (california )

I have United HelathCare POS California SBC. And I've been denied once so far on the panni. I'm on my Second appeal. The UHC says that SBC says that a panni, even after over 100 lbs is cosmetic, I had letters from my Primary abd my surgeon stating different. Also I have a double hernia. If I get denied agian my Doc sais my next step would be to appela to an outside appeals place maybe even to the state level. What can i do to get prepared for this? PLease any help will be greatly apprecaited!!!

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