Question:
Denied for exclusion, anyone out their appealed and won?
I was recently denied based on the basis that it was not a covered benefit. The exclusion states"no treatment for obesity not due to organic causes." I am appealing based on a)there is an organic cause-genetics b) the should be terminology is wrong-it should say morbid obesity not just obesity c)the surgery is not for obesity so much as it is for the co-morbidities I have. They are: hypertension, gastric reflux, asthma, chronic venous insufficiency, peripheral neuropathy, and osteoarthritis is my neck, lower back, hips,knees, ankles, and wrists. — cdonges1 (posted on June 17, 2005)
June 17, 2005
There is a web site that has a class action lawsuit to try an get these
insurances to pay for weight loss surgery .You could look it up at
www.obesitylawsuit.com.Or you can click on Main Entrance on the home page
it will show you where to go plus answer some more questions. I hope this
helps you out. Not sure if it will answer yur question but it doesn't hurt
to look. Good Luck Patricia Stephenson
— Patricia Stephenson
June 17, 2005
There is a web site that has a class action lawsuit to try an get these
insurances to pay for weight loss surgery .You could look it up at
www.obesitylawsuit.com.Or you can click on Main Entrance on the home page
it will show you where to go plus answer some more questions. I hope this
helps you out. Not sure if it will answer yur question but it doesn't hurt
to look. Good Luck Patricia Stephenson
— Patricia Stephenson
June 20, 2005
I used Kelley from Obesitylaw.com, she rocked. Please read my profile and
if you have any questions, just contact me. (RNY LAP 12/17/05) six months
out and down 81 pounds :)
— jenniferw
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