MsWhammie
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My letter was a combination of scientific references with explanations of how the information applied to me, and me telling them why I thought the sleeve would be the best option for me. If you PM me your email, I would be happy to send it to you for your reference. Most of it doesn't apply to many people, but would give you an idea of what works. BCBS of North Dakota sent my appeal to an external review board on the first appeal, which I thought was strange. Apparently another member had the same thing happen with BCBS of Illinois. I think they are getting ready to just make it a main stream choice. Hopefully soon!