Question:
Will someone please help me?
I have just received my denial letter, I have been expecting. I desperately need to write one heck of an appeal letter. I would like to state all the health risk of my comorbidities and cost of care for those without surgery. I really need help, and any help would be greatly appreciated. Could anyone share thier letters or point me in the right direction to find the information I need? — Rebecca N. (posted on April 8, 2000)
April 8, 2000
Hi there. I am so sorry to hear about your denial! I will make one
suggestion about your appeal letter - do NOT focus on the money the
insurance will save through surgery by outlining the cost of your
conditions. You can, of course, mention it in a subtle way, but don't make
it your primary focus. The reason is that it is ILLEGAL for an insurance
company to make determinations based on financial considerations, and if
you make that an area of focus, their kneejerk response will be to outline
all the reasons that it's MEDICALLY not appropriate for you to have
surgery, in order to cover their butts. Rather, try focusing on the ways
that this one procedure will address all of your health and psychosocial
problems. Include photos in your appeal, taken in underclothes if you are
comfortable with that. I know it sounds weird, but quite often the doctor
reviewing your case doesn't see you as a person, but rather just a
"medical condition", and it helps for them to have a visual on
what your obesity does to you as a person. Good luck, and let me know if I
can be of assistance.
— Kim H.
April 8, 2000
Hi, I am so sorry that you got a denial letter. But, dont give up. I am
more than happy to share my letter that I wrote to the insurance company
with you. If you want it please email my privately and I will send it back
to you asap. Good luck
— Lee Ann B.
April 8, 2000
I too am in the appeal stage. I found a great letter listed in the library
on this site. I printed it off and used it as a guide. Hope this helps
you. Don't give up the fight, best of luck.
— Donna A.
April 8, 2000
Sorry to hear about your denial. It will be easier to help you
if you can summarize the reason for the denial and say whether
you are covered by an insurance policy or by a self-insured health
plan. Also, what state do you live in?
— Kathleen B.
April 8, 2000
You should check out this web site www.obesitylaw.com/index.htm they may be
able to help you. God bless you and good luck.
— Martha D.
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