Question:
I NEED HELP WITH AN APPEAL TO MY INSURANCE COMPANY

ABOUT 3 MONTHS AGO I CONTACTED MY INSURANCE COMPANY (UNITED HEALTHCARE ) TO FIND OUT IF BARIATRIC SURGERY WAS COVERED. I WAS TOLD THAT IF IT IS PROVEN MEDICALLY NECESSARY THAT THE INSURANCE WOULD COVE IT. WELL 3 MONTHS LATER ALL TESTING DONE AND THE SURGERY SET FOR JULY 16TH I GOT A CALL FROM MY INSURANCE COMPANY ON THE 15TH TELLING ME THAT THIS PROCEDURE IS EXCLUDED WITH THE PLAN THAT I HAVE. I HAVE THE GIRLS NAME DATE AND TIME OF THE CALL 3 MONTHS AGO AND I WANT TO APPEAL THIS DECISION. IT HAS COMPLETELY DEVISTATED ME AND I WANT TO FIGHT IT IF I CAN. IF SOMEONE CAN HELP ME AND GIVE ME ADVISE I WOULD GREATLY APPRECIATE IT.    — TARA B. (posted on July 20, 2002)

July 21, 2002
Tara, yahoo groups has a gastric bypass group and the files have a sample appeal letter you might want to try that. I would also talk to someone higher at the insurnace co.
   — colleen M.

July 23, 2002
If they told you why it was denied, make sure they are telling the truth. They told me I was denied based on an exclusion with my company. My company's benefits rep said 'no exclusions'. Get the denial in writing and work from there. If you need more info, let me know. I have UHC, but a different form...so I'll help if I can.
   — CatLover1964