Question:
Has anyone won when their appeal went before a board / committee?

I am with BC/BS and I got upset because I was shoved to another person again today, so the 30-waiting period starts again. My surgery is scheduled for June 14! The last person who had my case said I needed one more letter from my previous doctor stating the last time I was treated for my weight and it would be approved. I supplied that, yet it was passed on. NOw they have no recollection of telling me this. How frustrating is that? Now that this woman just received it, she told me she has 30 days to review and get an answer to me. I told her about my surgery. She didn't seem to care. She has a committee meeting today but she didn't have a chance to look at my case yet since she's been on vacation. Then, I asked if it might possibly go in for next week so I could keep my date. She said she just didn't know, she has 30 days. She kept saying that. I have 30 days. I asked her if they didn't take into consideration the date of surgery. She said she would look at it but I have 30 days by law. So I asked if I should submit a letter requesting immediately review to the med director. She said to address it to the med director but send it to her...what good will that do? I wasn't happy. She knew and she'll probably deny me for it. I have a bad feeling. What should I do to help my situation?    — [Anonymous] (posted on May 30, 2001)

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