Question:
CAN SOMEONE ASSIST ME IN WRITING AN EXCELLENT APPEAL LETTER?

Hi everyone...Recently, I have been denied from my insurance company BC/BS for the Tummy Tuck procedure. They stated in the letter that they sent me back that it was considered "cosmetic". However, when the initial letter was sent in it was only a letter from the plastic surgeons office and not a letter coming from my primary doctor. They said I could appeal but do you suggest that my primary doctor have in there also a letter of necessity? Is this the key to get approved? I really need some help from anyone that has experienced this and got through to an approval. Also, anyone that would be kind enough to give me some advice to go about this. Please I need some help and samples of some appeal letters pleasssssssse! You can send me an email with the appeal letters to [email protected] Please only serious inquiries only. I thank you all in advance for your help. God Bless you and have a nice day!    — JONEEN R. (posted on January 7, 2005)

January 7, 2005
I got denied twice with my insurance and the first time I sent a letter with my primary doctor and more pictures. The second time my gastric bypass surgeon sent a letter of necessity. I guess that is what did it because I was approved. I will be having my tummy tuck Feb 9th.. I did have a appeal letter the second time but dont have it on hand but i know alot of people do on the message board. Just wanted to wish you good luck
   — Catherine B

January 8, 2005
I did these type of medical reviews for 6 years. What they are looking for is a letter from OTHER providers that have documented history of problems. For example: Chriopractor and you've been complaining about low back pain often. Your family doc: the notes should mention red/rash under the panni area and a prescription given. You can also write a letter, however they only want MEDICAL necessity info. They figure you want it no matter what, and your PS is making the money. You might want to MAKE your history path now and then try again later. You could also take photos of your red panni area and tell them you have been self treating if you don't have any other history. This might work. Best of luck!
   — ZZ S.

January 10, 2005
Check out www.obesitylawyers.com he has some samples on there I believe
   — superellen