Denial question

[peacequeen 434]

Just in case I'm denied, I was wondering if any of you that were once denied but appealed and made it through could share what you did to make them decide in your favor?

[his2my2our4 120]

Hopefully it wont even be an issue for you!! My first answer from United Healthcare was a big ol' no. I had submitted everything they requested but once it was all in they said that they have an unwritten requirement (was not in my print out of requirements and was never told to me in any of the 5,000 calls I must've made to them) the 5 year weight history. I submitted the extra info and was then told that they had closed my file and couldn't just re-open it. I immediatly called my dr in tears and he said he'd do a peer to peer review. Basically, it's him talking to someone on their end...sort of selling my case. I'm not sure what he said but it did do the trick. Like I said, hopefully you wont need to go any further with your case but if you have to, having the dr call himself seemed to really help!

Good Luck to you!!

Kristin