Question:
Appeal letter for Abdominoplasty for someone with back problems

I suffer from severe back problems and even with letters of support from my orthopedist and plastic surgeon, my request for adominoplasty with BC/BS was denied. I have lost over 180 pounds and am extremely close to goal weight. My only problem is that I carry a whole lot of excess skin in my stomach which is causing me sever back problems. Is there anyone out there that can help me with a sample of a letter to appeal. Every day I have to wait for this surgery just causes me more pain... By no mean is this "cosmetic" as the insurance company states. Help!    — c B. (posted on June 23, 2003)

June 23, 2003
I take it you have only gone thru level one. Appeal. Level one BCBS is useless. When I had mine they had a 'urologist' review it. Just a note; with bcbs you can skip level one appeal and request a level two. level two didnt get any more info but they approved it. write your letters and go for level two... Im sure you'll get it! If not level three a plastic surgeon will be review it. Also include the 'letter' off the web from the plastics site showing that surgery after wls isnt cosmetic. good luck.
   — star .

June 23, 2003
You can read my profile, I have my appeal letter posted there which I got off Sue Barr's website. I also have a commentary by Dr. Cappella that explains why some have loose skin and others don't. When you file your appeal, you want to stress this is reconstructive surgery not cosmetic surgery. Good luck
   — bbjnay