Question:
Has anyone been told they can't appeal request for pre-certification?

I was told there I should have the surgery and pay for it myself and then file a appeal. They said I could appeal the claim but not the pre-certification. I was also told there was no way to get the exclusion changed.    — B. S. (posted on August 13, 2002)

August 13, 2002
That doesn't sound right to me. I would send them a letter and cc the state insurance commission. That may shake it up a bit. Good luck.
   — Ann B.

August 13, 2002
I agree with the previous poster--that doesn't sound right. I know a couple of people who have done this and one got reimbursed and the other didn't. Also, do you want to take the chance of complications and greatly added expenses? There should be a state insurance commission in your area who can advise you on this. In the meantime, make sure all your "ducks" are in line with paperwork and documentation of all your co-morbidities and diet history. The one thing I had to do was get 12 weeks of physician supervised dieting documented before I could get approved. (I even lost 41 pounds in the meantime.) So use the time wisely until you get it sorted out. Best of luck to you!
   — Cathy S.