mina 27 Posted April 1, 2011 So I got denied for the vertical sleeve from BCBS of Tenn because it's investigation. If I want to resubmit my claim for lap band or the roux en y there would still be problems since in 2007 I had lost 10% of my body weight, etc etc... I am so piss... I Will be going to Mexico. Share this post Link to post Share on other sites
warrior68 16 Posted April 1, 2011 I went through numerous denials, and finally won, if they are denying you based on Experimental/ investigational you can definitely beat that with no problems. I Have BCBS in NY and appealed the investigational / experimental denial and won easily, call your surgeon, and primary, all three of you need to write strongly worded letters to BCBS and submit them. You should call BCBS and ask to talk to a customer service supervisor, and explain that you want the appeal handled as a expedited appeal, this way the only have one week to answer your appeal. There are people on here that have copies of their appeals letters, and links to websites with appeals letters that have worked well. Good luck and dont give up. Share this post Link to post Share on other sites
doggz109 41 Posted April 1, 2011 Appeal, Appeal, Appeal......you deserve this. Go get it. Share this post Link to post Share on other sites
Margaret 4 Posted April 1, 2011 Don't give up! Have your surgeon's office write a letter, your PCP write you, and you appeal immediately by phone, etc. Good luck! So I got denied for the vertical sleeve from BCBS of Tenn because it's investigation. If I want to resubmit my claim for lap band or the roux en y there would still be problems since in 2007 I had lost 10% of my body weight, etc etc... I am so piss... I Will be going to Mexico. Share this post Link to post Share on other sites
vol1cathy 1 Posted April 1, 2011 Mine was denied at first for the same reason and my surgeon talked to them directly and got it approved. Share this post Link to post Share on other sites
MRSKOUBiK 27 Posted April 1, 2011 I'm sorry! APPEAL! Share this post Link to post Share on other sites