Appeal Accepted!!

I posted this on the main board also, but wanted to be sure those who come here for questions see it too.

I have only posted a couple of times, but I read the posts daily and just wanted to encourage those who have been denied by their insurance not to be afraid to appeal.

I was denied in December and was advised, on the message boards, not to appeal until I finished my 6month surpervised diet.  A couple of weeks later, I got a message from Gary on the Insurance message board and he advised me to go ahead and appeal.  He said that I had nothing to lose. I gathered as much additional information as I could, called my PCP again and asked for more records and Gary was RIGHT!!!.  I got a verbal acceptance on Friday and I am hoping to get it in writing this week so I can schedule a surgery date. So, keep trying, DONT GIVE UP.  I never would have gone ahead and appealed and I would be mid summer getting my surgery, but now I might be able to get a date in the next month. Linda

Linda, That is great!  I also received a denial letter -stating I do not have 'Life-threatening" co-morbidities and I had not done the three month diet.  I am in the process of appealing.  I have started my diet with my PCP, but sent a letter to my insurance detailing my co-morbidities and reiterating my diet history. I am waiting for a reply.  I figure I may as well try.  If nothing else, it shows I am committed and not giving up. Best of luck, Lisa R.

Congratulations Linda! How exciting!!! I am at the denial stage. I plan to appeal but just don't know where to start. I wrote to Gary, but never heard back.  =0( I wrote and appeal letter and had an OH friend look at it, and she said it was all too personal and not enough medical. Meaning I need to prove to them why I fit the criteria and need WLS. I started my needed 6 mo. weight loss program...weigh****chers. I wasn't sure if I should appeal during it or not. Now from your post, I see it is possible.  What did your appeal letter say? How did you word it? Would you mind sharing a copy of it with me? Thanks so much, Susan =0) ps...keep in touch. I cannot wait to hear when your surgery date is!!!