appeal letter help

kalio
on 6/6/11 3:30 am
 Ok I received my denial letter and now I need to write my appeal letter.  Any suggestions as to what I need to put in it other than the obvious.  Any help would be greatly appreciated.
    
Elaine2
on 6/6/11 3:38 am - Atlanta, GA
Didn't have to use one myself but here's some help for you on this site

http://www.obesityhelp.com/morbidobesity/information/wlsjour ney/insurance+trouble.php
kalio
on 6/6/11 3:45 am
 I probably should have stated that I am appealing for a revision from band to sleeve and have been denied and now I need to send in an appeal letter.  I just want to make sure that I give them what they are looking for.  I want this band gone!
LittleMissSunshine
on 6/6/11 3:49 am
Was it denied on the basis of the VSG still being an investigational surgery?  If so, feel free to tweak my appeal letter (yes, I won) to suit your own needs.

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Jenns Livin free
on 6/6/11 3:52 am
I have a TON of stuff--from letter to documentation that it is no longer investigational.  I am a band to sleeve revision.  I never actually had to send in the information because time was on my side (my dr. tried to get approval in Jan--denied and again in March--approved).  If you pm me your email, I will send everything to you.
Jenn
Lovin' life...finally! Jenn
HW 324 Lapband SW 290(9/14/09)  VSG SW 254(5/23/11)  CW 210 GW 160
Approved on 3/10/2011 for Revision to VSG. Lapband removal 3/22/2011.VSG surgery 5/23/2011
      
LittleMissSunshine
on 6/6/11 3:54 am
Sorry, I must have been typing up my last post when you were adding your second one.  I don't have any insight on a band-to-sleeve revision appeal, but hopefully someone else does.  Good luck!

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cweintra
on 6/6/11 5:00 am - West Bloomfield, MI
I noticed your Dr is Kole. I had my surgery out of the same office (well the Novi one) with Dr. Katz and Jennifer @ the novi office was very helpful with insurance information - I'm sure shed be able to help you with what to write in an appeal :)
Carly Rose
        
kalio
on 6/6/11 11:39 am
 I love Dr. Kole and he has assured me this is the way to go.  I have a good insurance coordinator here to but she wants me to write the letter and she will help me tweak it if needed so thanks for giving me Jennifers name maybe it will come in handy.  
    
B. Bap
on 6/6/11 7:44 am
I do not have my letter posted, but here is some additional information that I found proving that VSG is acceptable procedure.
It is a forum topic I posted

http://www.obesityhelp.com/forums/VSG/4393702/More-research- information-for-VSG/#36321965

If you do a google seach on the titles of the documents you will find theinformation.


I  hope it helps.
kalio
on 6/6/11 11:37 am
 Thank you everyone for all of the helpful information.  Hopefully all goes well I am so ready to get rid of this band.  Nervous about the sleeve but ready to do this!!
    
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