Starting my appeal...AGAIN! Need any and all help!!!

Well, life has settled down a little and I want to start on my appeal again. I just lost my mom on March 10 due to complications from diabetes and I do plan to use that in my appeal this go around. Here's a quick recap... I have Great Lakes Health Plan, my surgeon is Dr. Micheal Wood. I submitted my paperwork for approval in Nov and was denied and I submitted an appeal in mid December and was denied once again for not having the 12 months of doctor supervised dieting. I know there are others out there with my insurance that was denied for the same reason, but later won an appeal and I feel like if they can...I can too and darn it I will! So hear ye, hear ye!!! All you excellent letter writer and folks with good ideas, I need any and all input! I'm a pretty good writer, but two heads are better than one and 4 is better than 2...You get my drift I'm sure! I have a copy of the last appeal that I sent in and as I said any suggestions are welcomed! Thanks guys!!

The copy of the last appeal is in my profile....meant to type that, but my fingers mover faster than I can think at times!

Ack....dangnabbit. I just went and wrote you a nice lengthy reply and I lost it. Sorry hon. I will have to redo it later. Kids are getting up and need food. Just know you are in my thoughts daily. Kids and I have you in our prayer box and been praying daily for you. Positive vibes Megan

Aww, my sweetie...I love you!!! Thanks for keeping me in your prayers!! I miss emailing you, but I know we have all been busy lately... Will you be coming to the Detroit event???

I know when I was denied for my plastics, what I did was write a personal appeal letter myself then took it to my doctor first and asked her to do the same on my behalf. My letter contained all of the medical issues I was having and having her confirm them with her medical stamp of approval in her own letter really helped and the appeal went through. Hope this helps. Wendy

That's good...I will do that! Thanks!!!

I am sorry you are having to fight so hard. It can be very frustrating from others I have talked to. One thing I can remember is that people have a better chance of winning there appeals when they had a face to face with the board. It is hard to do, but according to others very worth it. I will keep you in prayer that you will get a positive result for your efferts. Good luck and God Bless---Toni

That's a thought!! Exactly how would I go about doing that? I guess I would need to contact the lady handling my case right??

I was going through the same nightmare! I was denied- then went through the MMPC weight loss program- that was a joke. applied again-denied- thought we (doctor) appealed but doctor didn't. Waited six months then reapplied to have surgery. I sent pictures of me- my weight history- sleep studies- didn't matter. I stop breathing 78 times an hour. Didn't matter. I was denied again last week. Called the doctor office to appeal and was told they would not help me again without me going to a weight loss program again. So I said screw them - I have been looking at ways to finance this myself. We looked at credit cards -everything possible and finally found out that our credit union will give us a home accituty (sorry can't spell it) loan for 100.00 more on our house payment. I also decided to have the surgery through Bariatric Treatment center. The best choice because they pay for everything. I am not going to let my insurance company kill me or wait any longer. I am 54 and 275- 5 foot 3 inches. Good luck to you and don't let them stop you. Nancy Solomon