OT: Plastic surgery denial
Hi, I put OT beacause I have question about plastic surgery procedure and would like to ask here , I know a few people who is really good with this.
I tried to get approved for breast lift/reduction , i have Oxford and it is covered , but should be medically nessesary.
I got deniel twice from Oxford and denied from external appeal.
What is my next step?How can I appeal external denial?
Please help, I need to get rid of those huge breasts!.
Thank you.
Alla
I tried to get approved for breast lift/reduction , i have Oxford and it is covered , but should be medically nessesary.
I got deniel twice from Oxford and denied from external appeal.
What is my next step?How can I appeal external denial?
Please help, I need to get rid of those huge breasts!.
Thank you.
Alla
PART 1 VSG 03/28/2006; PART 2 DS 01/31/20007
If you've had an external/independent medical review, the decision is final, unless you have the right to file a federal ERISA lawsuit - which is cost-prohibitive unless you can do it yourself.
Your only recourse is to find another reason for medical necessity - an intractable rash, for example, and start all over again with another reason.
Or self pay.
Or change insurance companies.
Your only recourse is to find another reason for medical necessity - an intractable rash, for example, and start all over again with another reason.
Or self pay.
Or change insurance companies.