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Appeal Letter

I was denied by my insurance company and plan on appealing the denial. Does anyone have a copy of the letter they submitted for the appeal? Any suggestions for the appeal? Any help would be greatly appreciated.

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Your appeal letter will depend on what insurance you have. Most insurance companies have appeals process that you have to follow. I would advise to find if your insurance covers the procedure if so ask what is the criteria is it may be that you are just lacking something small. If so then do what it still missing and have your doctor resubmit.

MC

Your surgeon's insurance person will know exactly what your insurer requires. Will they handle it for you?

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I need diabetes, hypertension or heart disease in order to qualify. I have none of these. Do I have a leg to stand on? My BMI is in the 50's and I have depression and high cholesterol.

What kind of insurance do you have?

  • Author
What kind of insurance do you have?

BC/BS through the plumbers union.

Keep fighting because I don't have any illness and I got approved. If all else fails have a sleep study test, if your lucky maybe you have sleep apnea :)

I just sent you a PM w/an excerpt from one of my appeal letters that you might find useful. Best of luck to you!

If all else fails have a sleep study test, if your lucky maybe you have sleep apnea :)

So if I have moderate OSA I can qualify easier with my insurance? I have United Healthcare and they cover alot of stuff - I saw Dr. Grossbard & Dicicco (I think?) are in my network, but can't find bariatric services any suggestions?

I also have United Healthcare and they covered the surgery with just mild sleep apnea. I have to say that my surgeon's staff also were excellent in working with them (so that may have had a lot to do with it). In any case, had my surgery last Tuesday, I feel great, have lost 12 lbs already. So please don't give up!!!

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