Second-Level Appeal - Any Luck?

[livvsmum 2,369]

So my insurance fully covered my panni & abdominoplasty, but they denied my brachioplasty. It makes no sense to me because when I sent in the paperwork, I have the same medical documentation for both my stomach (which they covered) and my arms (which they denied). Anyway, I appealed it and it was denied again. Now at the end of October I appealed it a second time and it is being reviewed by "an outside reviewer". I'm just wondering if anyone had any success getting a 2nd-level appeal approved or getting an appeal reviewed by an outside party approved. Waiting the 30 days is killing me. I'm kind of thinking that if they deny it this time, no one is going to approve it since it's not being reviewed by the insurance company. Sigh...... It's not the end of the world. My main concern was the Tummy Tuck, but this would definitely be icing on the cake. :-)

[RILEYSMOM22 344]

I didn't realize that was something they would ever cover. I was told that it is cosmetic and insurance companies won't even consider it. Good Luck with your appeal.

[ausmith 374]

So my insurance fully covered my panni & abdominoplasty, but they denied my brachioplasty. It makes no sense to me because when I sent in the paperwork, I have the same medical documentation for both my stomach (which they covered) and my arms (which they denied). Anyway, I appealed it and it was denied again. Now at the end of October I appealed it a second time and it is being reviewed by "an outside reviewer". I'm just wondering if anyone had any success getting a 2nd-level appeal approved or getting an appeal reviewed by an outside party approved. Waiting the 30 days is killing me. I'm kind of thinking that if they deny it this time, no one is going to approve it since it's not being reviewed by the insurance company. Sigh...... It's not the end of the world. My main concern was the Tummy Tuck, but this would definitely be icing on the cake. :-)

Did you have any luck with this ?

[shakia90 0]

What and how much documentation did you provide?