Sample Insurance Appeals Letters

June 6, 2001

Hi everyone,

I had a number of people who asked me for samples of letters I used

to help win my insurance appeal. The denial for my surgery with Dr

Pomp was based on their claim that Gastric Bypass surgery was

available In-Network. Yet they had NO-participating surgeons

performing the BPD/DS.

I have uploaded these sample letters to the Files section of this

group list. It is under

Insurance Appeals. I XXXXed out the names (to protect the guilty:-)!

The emphasis of these appeal letters was to show that not all

gastric bypasses are created equally; the BPD/DS is a *unique*

procedure with distinct differences from the RNY. Also, why the

BPD/DS was better suited towards my specific situation.

Please feel free to plagarize whatever you feel may be helpful for

your case. My only request is that, if you are successful, please

come back and tell your story so new potential pre-ops can learn from

us. The letters are written in MS Word 97. If you can't read these

for any reason, please email me. Hope these can help!

Terri Hassiak

BMI 60

Appealed " Out-of-Network " Ins. Denial - AND WON!!!

BPD/DS with Dr Pomp on 6/25/01

email(no spaces): bunsofluff @ hotmail.com

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