I asked my doctor's office about the peer-to-peer and was told that the BCBS didn't request it! Of course I responded that I thought it was the responsibility of the doctor to request it. I didn't know that existed until I read it on here and now her office is acting like it's too late. I think my best bet might be to start seeing another doctor and pursue an appeal. The issue now is finding one with a good track record of winning appeals!
I would love to know more about your appeal. I also have BCBS and was denied the conversion surgery. They look at it as two separate surgeries and denied each one for different reasons.
I've been holding off on my appeal because I don't know that the "magic words" are to change their minds.
I guess I didn't realize there was a list for approval. Where do you find that list? I just assumed the PCP did the referral letter to whomever you told them. Seem I have a lot to learn!
That's great! What doc are you using? I called my insurance co. (BCBS) and they said it was covered. I just have to get a referral from my PCP. I've been reading all I can about the various docs in my area and have it narrowed down to two, I think! Maybe I'll be right behind you. Let me know how it goes. Good luck!
Carla
Anybody have BCBS? I'm just in the "thinking about it" phase and still have many question. I live in the Atlanta area and would love to hear from some locals!