Appeal Process

[helleva 22]

Hi,

So today I called my docs office to see how the peer to peer went. They told me that the peer to peer was not approved on the spot because my insurance needed more paperwork. Now, my docs office is going through with an appeal. Can anyone please tell me your experience with the appeal? How long did it take? What was the outcome? How did you get notified?

thanks,

denise

[chitowngirl 886]

If it was denied because of lack of info then once they get all the info they need it shouldn't take them too long to review the request. However I was denied because my insurance felt I wasn't consistant enough with my 6 month diet and I had to redo the diet.

[helleva 22]

Thanks,

I'm confused a bit because my denial letter states I was denied because something like "its not medical necessary due to comorbilities have not failed with medical treatment". I'm not sure what is going on. My coordinator said everything will be okay but I'm so worried that I will be denied again. thanks for sharing and I hope everything works out for you after the 6 month diet.

denise