Question:
My appeal was denied by Blue Cross...HELP!

On 2/19/02 I received a letter from BC stating that they are upholding the medical groups denial. Now if I want to continue this quest for WLS, I will have to change PCP's and start all over. I live in Redlands, CA and my surgeon is (or should be)Dr. Kelly Francis from Dr. LePort's office. Does anyone know of WLS friendly PCP and MEDICAL GROUP in the Orange County area? I hate this! I feel so hopeless. Please help!    — Carole S. (posted on February 22, 2002)


February 22, 2002
Find out how many appeals you have. If you have another level of appeal get an attorney to help you, Walter Lindstrom has been very successful for many people (wls himself)Best of Luck
   — ZZ S.

February 22, 2002
What was the original denial based on? Exclusion in the policy? Not enough information? This 'second' denial doesn't sound like it's based on any new or additional information, just saying that the original denial still stands. You need to respond to the issues in the original denial.
   — garw

February 22, 2002
I have Aetna and my original request was denied. I wrote a 4 page letter outlining my weight issues and weight lose and diet history and submitted letters from my Chiropractor, Weight Lose Clinic and anyone else I could think of. I think the thing that helped me the most was that I was already approved for a procedure to correct a reflux problem and so I just pointed out to Aetna that since I was already having something done, why not this procedure instead to cure both problems, weight and reflux. I have my surgery March 6th, just 11 more days, good luck to you.
   — Tonna N.




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