Denied!

[wannabehealthy 0]

Hi there, it's been a while since I've been on the board, I've been a busy bee, doing all the requirements for the sleeve surgery- nutritionist, classes, homework, lab tests, physical, psychologist evaluation- all came out good and ready to go, only problem is I have been DENIED the surgery due to Blue Cross Anthem states it is "investigational"! I am heartbroken, but I won't give up. I am determined to fight this all the way to the state level. I believe in my doctors at UCLA and my previous surgeons Dr.Francis and Dr. Leport, as well as my primary care doctor, who has known me for over 10 years, when they tell me that this tool will work for me! I am beginning my research for my appeal and would greatly appreciate any advice, help~ anything that will help me win my case and make this dream for a better life a reality. Time is no factor for me, I am a patient person and will continue with my low-calorie diet and exercise regimen in the meantime.

Much Love,

Kathy

[Tiffykins 673]

I'm sorry to hear of your denial. I've compiled a bunch of other people's appeal letters. The great thing about these letters is that the research and references are already cited for you. So you can read, copy/paste which parts all pertain to your specific needs. Best wishes on your appeal.

Here are some links of appeal letters and stories to help guide you in getting your appeal letter together.

One common thing that a lot of appeals are won on is the fact that we can take NSAIDS. RNY patients can not due to the ulcer issue.

These appeal letters already have all the research links and articles cited within them. So you may have to copy and paste, change the wording around to fit your specific needs, but these are some pretty awesome letters.

Some of these patients have won some of them have not been able to.

The Diary of a Fat Woman: Deny Deny Deny!

Unapproved for Sleeve - Ready to CRY

vsgappeal: Appeal Letter

My appeal draft w/references

ObesityHelp.com - Insurance trouble

Here is the most recent updated statement from the ASMBS on the VSG.

http://www.asmbs.org/Newsite07/resou...astrectomy.pdf

Page 5 has some amazing articles for further research to help you with your appeal letter.

I personally did not have to deal with this, but I try to give people dealing with appeals the information I've gathered over the last year or so.

[wannabehealthy 0]

Thank you so much! I am not going to give up-never! I also received help from another great gal who gave me 2 similar letter, so I wrote my appeal today. I will PM it to you, and if you don't mind, can you read it and PM me any further suggestions? You and several others have been so helpful, I just would muddle through helplessly without you!

[sleevegenie 0]

Hey Tify, i won my appeal, my surgery is 5/28 two weeks, can you believe it, i am so excited, i just wanted to thank you for being there for me, you have helped more than you know, i got a great letter together with help from people on OH and i am so happy i don't know what to do with myself, now i have to do the preop diet, what was your diet? one week? two?? low fat high protien or liquid? ? omg two weeks, i thought she was gonna say how about july____ WOW