Question:
Any information for appeal letters on the cost of surgervy vs. fighting comorbs?
I'm looking for more information to submit with my appeal letter, specifically for numbers and costs of having the surgery vs. the cost of fighting the co-morbities. I can not find any specific numbers to fight the insurance company with, any suggestions? Thanks so much! — Gerklette (posted on April 8, 2002)
April 8, 2002
The way I started mine was I was able to go online and pull up all my
insurance claims for the past 3 years and see what my insurance paid and
what I paid. I copied those and totaled it up, then I called my pharmacy
and got a print out of all the prescriptions I have had filled and what
their cost was and what mine was. Compare that to the cost of the surgery
and that should be pretty black and white.
— K T.
April 8, 2002
Oh! and another thing I did was go to my orthopedic surgeon and ob/gyn and
other specialists I was seeing for my weight related medical problems, and
had them write appeal letters. The costs of a hysterectomy and hip or knee
replacement along with all of my already mounted medical costs made a
pretty nice looking appeal letter. I didn't get that far to where I needed
to use it, but I had it there just incase.
— K T.
April 8, 2002
I too am working on an appeal. My Endochronologist wanted to know the cost
of the surgery to include in her letter to the insurance company. (Mostly
to compare the costs of medication for diabetes, sleep apnea, hypertension,
a future knee replacement if I don't have the surgery...etc.)I spoke to
many people before getting an answer a week later. Basically I was called
and given an approximation of $30,000 - $40,000 from the center in MI, for
the center I am hoping to have the surgery through...in Bellvidere IL.
Hope this helps get it in the ballpark for you as well. Good luck.
— Deb K.
April 9, 2002
Hi! Go into the Library section of this site. There are appeal letters
there you can modify to your needs.
— grammie5
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