Question:
I have received 1st denial for surgery. Can you help?

Carefirst BCBS PPO of MD said that the surgery was investigative and experimental. I've written a lengthy letter to them today detailing history, etc., included listing of cases where they have insured for this surgery and a copy of HB665 in effect Oct. 1 2001 saying that insurers must include WLS. Any other suggestions of how I can get this through. Many thanks. Andrea    — AJC750 (posted on November 21, 2001)

November 21, 2001
Hi Andrea. I have bc/bs teamsters ppo and they denied me to for the same reason. Grrrrr. I was told they wont budge so I'm now going for the open ryn. they'll cover this one. Good-luck on your appeal it might work in your state.
   — [Anonymous]

November 21, 2001
Andrea, All I can say is that my husband was denied for the surgery and he became very angry and depressed over it. We have Cigna and when my husband appealed the approval came back within a month or two. So, the appeal process may work for you. Could changing insurance carriers be an option for you?
   — [Anonymous]

November 22, 2001
The Law passed for 10/01/01 is for insurance policies delivered in the state of Maryland. I see that you are in Delaware, but you can try it...contact the States Attorney General in Delaware and Maryland. Because they are BCBS of MARYLAND they are aware of the bill665 and should know better than to deny on the basis of "investigative and experimental" If you were in Maryland they would have to cover you by law that states it is necessary...not investigative and experimental. There has to be something to that. Good luck. I am in "appeal hell" myself. I wish you the best.
   — Patricia R.

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