Question:
NEED HELP W/ APPEAL LETTER!!!! PLEASE

I AM POST OP 2 YEARS. HAD MY CONSULT FOR MY TUMMY TUCK. LOST 187LBS. DR. SAID NEEDS DONE. INSURANCE DECLINED. PLEASE FORWARD SOME APPEAL LETTERS THAT CAN HELP. I DID MUCH RESEARCH PRIOR TO MY LAP AND HAVE A 10 PAGE LETTER OF RESEARCH THAT I HAVE SENT OUT MANY TIMES TO HELP PEOPLE GET THEIR SURGERY. CAN SOMEONE HELP ME WITH AN APPEAL.... I WILL GREATLY APPRECIATE IT. HEALTHNET, DELTA IPA. PLEASE DON'T POST OPINIONS OF NEGATIVITY FOR ME.... JUST SOME ASSISTANCE WOULD BE WONDERFUL AND GREATLY APPRECIATE. THANKS SO MUCH. [email protected]    — Patricia C. (posted on March 21, 2003)

March 21, 2003
Patricia, this site has an entire section on plastic surgey, including many tips for appeal letters. Head on over and start planning your attack. Be sure your letter addresses the reasons for the denial. Good luck!
   — Kasey

March 23, 2003
I'm not sure what you consider "opinions of negativity", but I believe the key for succeeding in appeal on reconstructive surgery is to have laid the ground work for medical necessity. The only way I eventually won on appeal was having a chronology of my doctor's visits and efforts to deal with the pain caused by the pannus. Cigna did not care about redundant skin; they cared that I had tried pain meds, physical therapy, personal trainers to build muscle strength, and had a documented history of skin complaints. That, and a long discussion at my hearing about the difficulty dealing with the large pannus on a daily basis. -Kate-
   — kateseidel

March 23, 2003
Here's a link to a lady's website where she posts her appeal letters: http://u1.lvcm.com/njtomato/appeals.htm Best of luck to you! - Anna
   — Anna L.