Appeals
Does anyone know of any websites where I could
find information on <br>appeals? I know that i qualify
for this surgery but I have been <br>denied. BMI 47
324lbs 30yrs 5′6". I just need a few pointers on
<br>writing an appeal. The insurance company flat out told me
the only <br>way they would cover is if I am dying.
(I already have degenerative <br>arthritis in my
knee, and co-morbidities WILL kill me in the long
<br>run..but I guess I am not close enough to death for the
insurance)<br>If anyone could give me some pointers or even tell
the me how their <br>appeals have gone I would
greatly appreciate it. Thanks. <br>My insurance is
Priority Health PPO in Michigan.
December 19th, 2003 at 2:41 am
I do know it is also iportant to document you
have been trying unsuccessfully and have had several
attempts to lose weight on your own too! And when you go
to the dr’s don’t minimize your symptoms… we all
do and it does not help us… moan and groan about
everything that hurts… how hard it is to sleep… how
painful it is to move… how disabling it is to walk…
and nevermind stairs! All this is what helps you in
the long run… I do know in writing an appeal… it
is better for you if YOU provide the
documentation… there are some dr’s that don’t do the best
presentation to support their claim.<br><br>i know in my case
I had been on phen-fen, redux, weight watchers,
doctor programs, and all failed! And it was documented
how hard I was trying and working with all my
doctors, so keep it up and chin up! I am sure you will
win… just remember YOU are worth it!<br>Cindy<br>open
RNY 8/2/99<br>preop 298<br>current 183<br>(5′8"…
size 28 plus… to a 14!)