Question:
I need your help with an appeal !!!!!!!!!!!

I have been denied by BC/BS of Texas. I need some ammunition to help me write my appeal letter. If you could email me a copy of your appeal letter or give me any suggestions on how to fight this I would very much appreciate it. Also, if you have any suggestions on how to speed up the appeal process I would love to hear them. I posted a question some time ago and just want to thank those of you who responded. I am overwhelmed by the kindness each of you shared. It is only with your encouragement that I have the strength to fight this. Please email me with any responses. Thankyou!! Gina Email: [email protected]    — Gina W. (posted on October 16, 1999)

October 17, 1999
You don't say what the denial was based on. If it was denied due to a policy exclusion I would contact an attorney (I understand that Walter Lindstrom is THE MAN). If it was based on Medical Necessity you can certainly appeal on your own, citing all the reasons and research proving this surgery is really necessary for you. I've decided that if I am denied the first time I will seek legal counsel immediately! I'm just not going to play games with the insurance company. Good luck in whatever way you choose to deal with them.
   — Morgan B.

October 17, 1999
CALL [email protected] She is so wonderful, she can help with appeals, mines is still in process but she is a great gal!
   — Stephanie L.

October 17, 1999
Gina. . . I have just been denied (the third time) by BC/BS of IL so I know how your feel. How can they say someone with a BMI of 54 does not meet the medically necessary criteria? Anyway, I have no health problems documented to prove necessity YET. My advice is don't leave anything out by assuming they know the problems of obesity. I would also advise not to take "not medically necessary" for a reason - I have asked for more of an explanation. I will be contacting Walter as soon as I have the results from my gallbladder test & sleep study. Good Luck - I know people with BC/BS that have gotten approval and sooner or later I WILL BE ONE OF THEM!
   — Mary P.

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