Re: DENIED< NOW WHAT??? HELP!!!

[Guest guest]

I dont know if ou are looking for an appeal letter, but you can work off this

one if you like. I was denied as well. i sent them this letter. I hope it

helps in some capacity. Happy Easter! and dont give up.Take care Sheryl

Sheryl MI.

Lap RNY 6-10-03

288-170=118lbs gone forever

159 goal/5ft 9in

[Guest guest]

I think I forgot to attach the appeal letter. i hope you can open it and that

it is indeed atttached, I am not too good with these things. LOL sorry.

Sheryl

[Guest guest]

Thanks a lot!

> I have been denied for the same thing, I am on my first appeal.

There is a great group on Yahoo! called cignassqueakywheels You might

want to check it out. There are a lot of helpful people there.

>

>

> Alice hardestyal hardesty@a...

> DENIED< NOW WHAT??? HELP!!!

>

>

> I was denied because I did not have 26 weeks of medically

supervised

> diet! I told her no, I only have 5 years worth. She said it had

to

> be detailed. I am so frustrated the doctor had documented

everything

> I have been on for the last five years. What do these people

want!!!

> Sorry I just have to vent, CIGNA SUCKS!!! Everyday that goes by I

> feel physically worse, My bP gets higher and higher not only

weight

> related but stress related. I am greatful my Diabetes is semi-

> undercontrol. But this whole process is driving me nuts!! If you

> guys have any advise or where I can get a sample of what they

need so

> I can give it to my PCP I would greatly appreciate it. Thanks in

> Advance,

>

>

>

> --------------------------------------------------------------------

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>

[Guest guest]

,

I am dealing with the same thing. What I have done is get the insurance

company, Aetna in my case, to freeze my appeal. I was denied because I don't

have the detailed documentation that they want. I too have been on a diet my

whole life and a lot of it was documented by my doctor but it still does not

matter. I am going through a nutrition program at my hospital to meet their

requirements. When that is finalized they will pick my appeal back up and go

from there. I was told some time ago that you will get on a first name basis

with the people at the doctors office, the hospital and the insurance company.

This is absolutely true. Talk to them and see what they will do.

Also, I got a document from my insurance company on the exact wording of what

they want and I took that to my doctor. And after talking with the insurance

company a number of times have come up with what they want. Keep digging. You

will find what you are looking for and meet their requirements.

Dora

DENIED< NOW WHAT??? HELP!!!

I was denied because I did not have 26 weeks of medically supervised

diet! I told her no, I only have 5 years worth. She said it had to

be detailed. I am so frustrated the doctor had documented everything

I have been on for the last five years. What do these people want!!!

Sorry I just have to vent, CIGNA SUCKS!!! Everyday that goes by I

feel physically worse, My bP gets higher and higher not only weight

related but stress related. I am greatful my Diabetes is semi-

undercontrol. But this whole process is driving me nuts!! If you

guys have any advise or where I can get a sample of what they need so

I can give it to my PCP I would greatly appreciate it. Thanks in

Advance,

_____