Question:
Can someone please email me a draft of an appeal letter?
My freind got a denial letter in the mail last week, and she is so distraught, she has nearly given up. Well, I'm her force of nature right now and I want to help her gain her perserverance and determination back. So any type format would help me help her. Thanks, Paula — cocodrop7 (posted on March 25, 2009)
March 25, 2009
You will find multiple appeal letters....there are good ones in
"Weight loss for Dummies" book, and if you google Weight loss
surgery appeal letters you will get some.
— kfgates
March 25, 2009
Hi Paula,
Why doesnt her DR. write the letter? That is thier part of the
process..isnt it? Mine did everything that was needed.
I wish yous the very best!!
— tootsie52
March 25, 2009
Thanks, I will check out that book. Her doctor told her it was her
responsibility to file and appeal. His staff is of no help either.
— cocodrop7
March 25, 2009
Try including pictures. Like a photo history covering at least 5 year span
(I included at least 2 from each year) and we all have pictures which
depict the truth about our weight. It does help to let them have a visual
instead of just a written appeal.
Good luck
cee
— ceecee127
March 26, 2009
I agree with what others say. I work for an insurance company and I can
tell you from experience the first thing she needs to do is talk with
someone in the appeals department and find out what the entire appeals
process is. Most insurance companies have 5-7 different appeals you have
to go through! It is totally insane. Her denial letter should have said
what her next option is, but she needs to know that if there are multiple
levels of appeal, it really doesn't matter that much what the first few
letters say. But she does need to start gathering documentation on studies
that have been done that prove that weight loss surgery works. The best
study is a swedish study that is considered the longest and most inclusive
and gives great undeniable information. That can be found in the New
England Journal of Medicine, do a search on the internet for Swedish weight
loss study and it should come up. At every level of appeal send article
that you have found that puts a positive spin on it, save the Swedish Study
for one of the upper level appeals. Get your regular doctor and your
surgeon to write letters stating your absolute need for this. My doc had a
great appeal letter that stated state laws on appeals and my rights if
something happened to me due to the denial. It is a long a tedious
process. If you can afford to hire (I think it runs about $500) the
Obesity Law firm, they are great and will tell you if you have any chance
of winning before they take your money. (I think it is ObesityLaw.com)
Anyway, good luck and be patient you have a long road ahead of you. But it
is totally worth it.
— brindledanes
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