Question:
Any information for appeal letters on the cost of surgervy vs. fighting comorbs?

I'm looking for more information to submit with my appeal letter, specifically for numbers and costs of having the surgery vs. the cost of fighting the co-morbities. I can not find any specific numbers to fight the insurance company with, any suggestions? Thanks so much!    — Gerklette (posted on April 8, 2002)

April 8, 2002
The way I started mine was I was able to go online and pull up all my insurance claims for the past 3 years and see what my insurance paid and what I paid. I copied those and totaled it up, then I called my pharmacy and got a print out of all the prescriptions I have had filled and what their cost was and what mine was. Compare that to the cost of the surgery and that should be pretty black and white.
   — K T.

April 8, 2002
Oh! and another thing I did was go to my orthopedic surgeon and ob/gyn and other specialists I was seeing for my weight related medical problems, and had them write appeal letters. The costs of a hysterectomy and hip or knee replacement along with all of my already mounted medical costs made a pretty nice looking appeal letter. I didn't get that far to where I needed to use it, but I had it there just incase.
   — K T.

April 8, 2002
I too am working on an appeal. My Endochronologist wanted to know the cost of the surgery to include in her letter to the insurance company. (Mostly to compare the costs of medication for diabetes, sleep apnea, hypertension, a future knee replacement if I don't have the surgery...etc.)I spoke to many people before getting an answer a week later. Basically I was called and given an approximation of $30,000 - $40,000 from the center in MI, for the center I am hoping to have the surgery through...in Bellvidere IL. Hope this helps get it in the ballpark for you as well. Good luck.
   — Deb K.

April 9, 2002
Hi! Go into the Library section of this site. There are appeal letters there you can modify to your needs.
   — grammie5