Insurance Appeal letters ~ please help!

Natalie D.
on 12/27/15 7:39 pm, edited 12/27/15 8:12 pm

 

 Hi all,

 

I am currently in the process of doing the 3  month diet with psych eval coming up in Feb to complete requirements for  BCBS revision to RNY. I have a feeling it will be a fight as they will try to claim I was non compliant with band or do not have all the records they need, so I want to prepare as much as possible meanwhile. Can you please share some of your appeal letters that worked?

 

Some background: I was banded in 2007, been a struggle ever since, wasnt able to lose even half of my extra weight even though I followed everything to a T, the only thing I  didn't do for a while was follow up as I didn't have insurance and then move out of state, that's why I expect BCBS to deny me. 

 

 

 

Thanks so much!

 

Nat

 

 

DEBGG
on 1/14/16 2:07 am

Ive had to do all this before. It's quite the pain in the butt. I had a different ins co also. I googled how to write an insurance appeal letter, got every type of record from every dr I have ever seen, a letter from my pcp and  mailed it in with delivery signature confirmation. Make sure you do that because they will say they never received it. After they got it, I have them 5 business days, then I grabbed my copies and called them every other day until they approved it! Unfortunetly I had a bad experience with the band, after all that trouble, and had to have it taken out a month after getting it :(.  That was in 2008 and since then my health had declined, I have diabetes and am in the process of RNY. It's a long hard process for an appeal but stay on them!!! That's the key! Good luck!!

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