Question:
Im interested in using Walter Lindstrom for my appeal whats my next step?

It looks like I may not get an approval. I'm interested in using Walter Lindstrom for my appeal. Can someone help me with my next step. I am unable to provide 12 mths of supervised dieting. How much will it cost? What are the odds of him getting an approval for me? If anyone has used his services your comments would be greatly appreciated or email me at [email protected]    — lalulan (posted on December 21, 2002)

December 21, 2002
I know nothing about WL but I can tell you it is possible to win an appeal on your own. It will require dedication like you may have never had, but then again you are fighting for your life and that can be a huge motivator. Hit the internet, library etc. and learn, learn, learn. Education yourself on all of your co-morbidities and what that means to your overall health long-term and how WLS will reduce or eliminate that risk. You need to be able to talk intelligently about this surgery and how it relates to your case, in your sleep. Once you have the knowledge and confidence to take on the insurance company, write the appeal letter of your life. Demand to present your case to the appeal board. Any initial appeals will likely be reviewed by a staff nurse or doctor with the hopes you will not pursue it further. However, you have the right to a fair appeals board hearing so you can present your case. There is also the state insurance commissioner.<p>All of this can be done with little to no money and in my opinion has a better chance to being approved because you have invested yourself in your fight. The board will hear from you personally and what this surgery will mean to your life.<p>I know of what I speak. I went through 2 appeals on some claims that were denied payment. I then took it to the Department of Employee Trust Funds, who hires BC/BS to administer it's self-insured policy. I'm a state employee but that doesn't really factor in here. You are still entitled to an appeals board hearing. The DETF's reviewed it and initially was siding with BC/BS and tried to convience me to let it go. At first I kind of said yes and then I got PIS_ED! I called back and said NO, I wanted the chance to present my case. Because BC/BS had royally goofed up the appeal process by not letting me attend the 2 previous appeals, they were forced to do a 3rd appeal. It took 6 months for them to do their thing, but when I got the opportunity to present my extremely well-organized case with tons of supporting doctor's notes etc., I WON! Two of the three board members congratulated me on how well organized the information was and how easy it was for them to know what I wanted them to get out of the various doctor's notes (I highlighted the things). As I pieced together my whole medical history and how everything tied in the doctor on the board just kept shaking his head yes as to what I was saying that it was true and really could not be disputed. It was a long process but worth it! Even if WL handles your case it will be very costly and will take a long time, so what have you got to lose to do it yourself. Only you can truly tell your story as you have lived it! I know it sounds scary but believe me the insurance goblins can be tamed and you will be so much more insurance savvy and will never again accept a NO without fighting for what you are entitled to. Good Luck!
   — zoedogcbr

December 22, 2002
I hired Walter Lindstrom in Nov. I could pay $450. AND IT WOULD TAKE 4-6 WEEKS BEFORE MY APPEAL LETTER WOULD GET OUT TO AETNA! OR I COULD PAY $1100.OO AND THE 23 PAGE APPEAL WOULD BE AT AETNA WITH IN 72 HOURS, THATS WHAT I DID! PAID $1100.00.. AETNA RECIEVD MY APPEAL NOV. 20! THE FIRST WEEK OF DEC, THEY SENT ME A LETTER SAYING THEY NEED A 6 MTH DIET SUPERVISED! WELL THIS IS WHAT I WAS DENIED FOR! THIS IS WHAT I STILL DONT HAVE! MY 6 MTH SUPERVISED DIET WILL BE UP IN APRIL! HOPE WALTER WINS THIS APPEAL BEFORE THEN! THEN WHAT IS AETNA GOING TO DENIE ME FOR? I THOUGHT AETNA HAS 30 DAYS TO REPLY! GUESS NOT! EVERY DAY I GO TO THE MAIL BOX PRAYING FOR AN APPROVAL! GOOD LUCK! CYNDI
   — CYNDI B.

December 22, 2002
What does he do extra for that money? I'm curious about the difference in price with the two time estimations.
   — susanje

December 23, 2002
I hired Walter Lindstrom to do my 2nd level appeal letter. I was being denied because I didn't have 12 months of Dr. supervised diet history. It cost $350 over a year ago, although I hear his rates are higher now. I got approved within 3 days of him sending his appeal. It was worth every cent. Now am 9.5 months post-op and down 137 lbs. The odds of him getting you approved are going to depend upon your own circumstances and policy. The more weight related problems you have, the more likely you are to get approved. Good Luck.
   — Dell H.

December 23, 2002
I hired Walter Lindstrom to do my 2nd level appeal letter. I was being denied because I didn't have 12 months of Dr. supervised diet history. It cost $350 over a year ago, although I hear his rates are higher now. I got approved within 3 days of him sending his appeal. It was worth every cent. Now am 9.5 months post-op and down 137 lbs. The odds of him getting you approved are going to depend upon your own circumstances and policy. The more weight related problems you have, the more likely you are to get approved. Good Luck.
   — Dell H.