Guest guest Posted March 30, 2000 Report Share Posted March 30, 2000 In a message dated 3/30/00 11:39:38 PM Eastern Standard Time, MiniGastricBypass (AT) onelist (DOT) com writes: > I talked with my insurance company today. I am denied due to a policy > exclusion. They agree with the medical necessity but say that it's up to > the > employer to decide what to cover and what not to cover. I mentioned an > appeal and they said, " of course you have every right to appeal but I don't > think it will do you any good because it's not the medical necessity that is > > denied but denial due to policy exclusion " . This is a new one for me that I haven't heard yet. Get a copy of the policy and read it yourself. Have I sent you a copy of my appeal letter? If not, and you want a copy, email me privately and I will. I am still in insurance hell too, so I don't know if mine worked BUT I do think it has some good arguments in it. Basically, you need to read your policy and scour it for Medical Necessity. For example it may pay for all medically necessary stuff EXCEPT WLS which could give you an argument for discrimination. Anyway, appeal no matter what. It is worth the fight. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2000 Report Share Posted March 31, 2000 Thanks , I do have your appeal letter and I fill file the appeal anyway. I'm just very discouraged by what I've been told and don't expect it to do any good. Cindy In a message dated 03/31/2000 6:03:48 AM Central Standard Time, valmaboyz@... writes: > This is a new one for me that I haven't heard yet. Get a copy of the policy > and read it yourself. Have I sent you a copy of my appeal letter? If not, > and you want a copy, email me privately and I will. I am still in insurance > > hell too, so I don't know if mine worked BUT I do think it has some good > arguments in it. Basically, you need to read your policy and scour it for > Medical Necessity. For example it may pay for all medically necessary stuff > > EXCEPT WLS which could give you an argument for discrimination. Anyway, > appeal no matter what. It is worth the fight. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 1, 2000 Report Share Posted April 1, 2000 For , This is Deb in WY. Would you send me your appeal letter. I don't have and exclusion but I am only 102 pounds with a BMI of 37. However, I have multiple problems that are getting worse and I have NO intention of living the rest of my life miserable, so I am getting everything in order just in case. e-mail DK4498@... Thanks so very much Deb Quote Link to comment Share on other sites More sharing options...
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