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Not sure how to write an appeal letter

I was denied for surgery due to having my BMI dip below 35 for 2 out of 5 years. My next step is to file a member grievance which I guess is like an appeal. I'm just not sure where to start. I've had my obgyn write me up a letter that I'll send with the appeal I write. I welcome any and all ideas!!

Thanks!!

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    My surgeon's office provided me with a packet that included a template appeal letter. You should ask your surgeon if they have that available.

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