Question:
What do I say to get approval

I was denied and sent in a appeal letter, I was called today 6-21 and told I could meet with appeal board (kaiser) on the 24th Am very nervous as what to say I wrote a three page appeal letter should I just go over it or do I need something new? any suggestions would be much appricated thanks kathy    — kathy B. (posted on June 22, 2002)

June 22, 2002
I have not had the chance to go up to the board to try to get an approval but I would go and underline how much all the problems you have and will have in the future will cost compared to what one surgery will cost....and how it will be in there best intrests.....mention dicrimination if you can back it up....good luck and let us know how it goes!
   — EvningStar81

June 22, 2002
I never had to go to the appeal board, but I would try to make them understand a day in your life. Tell them how hard it is to move around or climb stairs. Explain your quality of life. And most importantly, show them what's in it for them. Remind them that it is more expensive for them to pay for open heart surgery than WLS. I read a story about one lady who tried to get her ins. to cover WLS. It would have cost about $23,000. They denied her and a year later she needed a heart transplant, which they did have to cover. The cost? Around $300,000. Your insurance company is there to make money. Sometimes they just need to see how much money they would be spending if they don't approve you. Good Luck!
   — Sarah K.

June 22, 2002
Kathy, I tried to email you, but your profile is not working. Email me, if you wish, so that I may provide some suggestions privately. From others who have made an appearance or teleconferenced at the review committee, have stated the committee acted very negatively towards each patient. Check out my profile, I have fought Kaiser "tooth and nail!" And have won each time! I would be more than happy to help.
   — ERICK B.

June 22, 2002
When I posted a message about his sort of topic, I got a message from Lee Ann Krause. Look her and and on her website is the notes from her meeting with the appeal board. She had Cigna insurance, but I am sure some of the things would work. E-mail me if you have any further questions!
   — sammygirlwpc

June 22, 2002
DO NOT try it yourself..Call the Lindstroms in California before its too late!!!!!greg
   — Greg S.

June 23, 2002
Dear Kathy, I did not get to the board appeal, but in my first appeal I sent along a letter from every Doctor that would write one. I wrote a heart wrenching (but true) letter to every Doctor that I have ever been to, asking for their help in getting approval. OBGYN, PCP, Back Surgeon, Orthopedic Dr. even my Foot Doctor. Some of these people I hadn't seen for a while but they wrote it anyway. Don't give up, that's what they want you to do. It would probably be a good idea to contact Walter Lindstrom before you go, especially if this is your last chance for appeal.
   — Susan W.