Filing a Grievance help
My surgeons office told me to file a grievance with my insurance company (they denied me first for something I could fix, now they Are denying my because my BMI is 38.5 and I don't have life threatening co-morbiditys) But I am, clearly, horrible with words. Does anyone know what I should say, mention or even format this? I'm so lost, and a little over whelmed :(
Please help!
(I also posted this in the Insurance area, but it doesnt get much attention)
Please help!
(I also posted this in the Insurance area, but it doesnt get much attention)
I would write them a letter with information form your medical record regarding your weight history, family history, diet history, physical problems, etc. You can even call them and ask if they have a special form for you to fill out which many of them do have. In fact, ask what information they want when you talk to them, too. Also, call your doctor's office and ask if they can help. They should be able to give you some advice since they know the system. Good luck.
I am my own hero...I save myself one day, one meal, one bite, one choice, one challenge, one step at a time...
I think I would ask your surgeon's office for advice. Since they deal with insurance companies all the time, they probably know what things you need to include in the letter.
I would format it like a business letter. If you goole that, you'll see how you put the address at the top, how to space it, stuff like that.
I would try to be as concise as possible. Make sure you get everything you need in there but try not to be too wordy. Try to stick to facts, don't just tell them how much you want surgery.
I would format it like a business letter. If you goole that, you'll see how you put the address at the top, how to space it, stuff like that.
I would try to be as concise as possible. Make sure you get everything you need in there but try not to be too wordy. Try to stick to facts, don't just tell them how much you want surgery.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
Hi Mary!!! This actually happened to me 6 years ago. My employer's insurance specifically excluded weight loss surgery. My surgeon and my primary care doctor both wrote letters to the insurance company on my behalf. Needless to say, because my plan was written with that exclusion it didn't matter if they wrote letters or not. I was still denied. Does your surgeon's office have a patient advocate or anything like that? Maybe you could ask for help from there??
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