Question:
I want to know how to get started with fighting my policy?

I already went to my PCP and got referd to a doctor and met with him and he said I an perfet to have this done he even said that they would use me to start the new way of doing this and give me a discount for being one of the first around here for doing this .But even after hearing all of this I was crushed because my insurane does not cover the surgury.I could not afford to do this any other way.PLEASE HELP I NEED ANSWERS.    — shawna S. (posted on September 19, 2001)

September 19, 2001
Most HMO's won't cover surgery... you may wish to consider switching to a PPO or PPOM, make sure there is no exclusion before you do though! Good luck and keep us posted!
   — [Anonymous]

September 19, 2001
"the new way of doing this"???? Personally, I wouldn't want anyone who wasn't very experienced with wls....and I certainly wouldn't want any surgeon who is offering "discounts" to attract patients. I know you are anxious for the surgery; but, "who" does the surgery is just as important as what type of surgery is done. You really don't want someone who is just breaking into this (very lucrative) field. What was the exact reason(s) for not authorizing the surgery? You can always appeal; but, a successful appeal must address the reason(s) for denial.
   — [Anonymous]

September 19, 2001
Not sure if this will help you or not. I list several web addresses on my webpage, among them a site where you can get useful step-by-step instructions on fighting insurance denials, including a link to the obesity lawyer. However, if your plan states that it simply does not cover the surgery under ANY circumstances, you may need to change insurance companies and start over. Anyway, look at the resources listed here. http://www.lkdobson.homestead.com and good luck to you !!!
   — Lisa D.

September 20, 2001
I would NEVER be anyone's guinea pig for testing out a new surgery. Forget that! How long has this doc been doing the surgery and which types? Why is he trying something new? What is it? As far as your insurance denial, why was it denied? Is it specially excluded? If so, you may have to be self-pay. There are too many questions for us to give you answers to your problem.
   — Cindy H.