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Re: Denials/Appeals

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I was denied on my first attempt at it and had to appeal. I would check with

your carrier as they should have a specific time frame. I know mine with Anthem

was 21 working days. They took every bit of the 21 days to give the decision

too but they did approve it. I don't know how your insurance works but for the

insurance policy I have there is one Dr. who no matter what the subject matter

is he makes the decisions approve or deny the first time through even though

it's out of his area of practice. I knew I was in trouble the first time

through when I got a letter of denial for my Xolair from the same Dr. as a

coworker had gotten a letter from denying her breast reduction surgery!! Once

you appeal something it goes to a specialist who does have knowledge of that

specific disease. Anyway, my experence was once it got to the subject matter

specialist it was fairly quick, it just depends how fast your insurance moves

that part of it. If it's not

clearly defined in your policy I'd call them.

----- Original Message ----

From: " Momto4wild1s@... " <Momto4wild1s@...>

Sent: Friday, September 7, 2007 1:18:24 PM

Subject: [ ] Denials/Appeals

Our insurance company denied Xolair for my son the first time we tried...So

we appealed that decision and are STILL waiting. Im getting frustrated.. .

did anyone else get denied and have to appeal? If so..what are the time frames

anyone has had to wait? I am anxious to get him started on this esp knowing

it will take a while to be effective!

Ginger

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