Re: Stormy you are right!!!!

August 3, 2000

In a message dated 8/3/00 1:47:12 PM Pacific Daylight Time,

steague99@... writes:

<< his group coverage does not cover the following expenses: #22.

Services or supplies rendered for weight reduction or treatment of

morbid obesity. This includes any surgical procedure or reversal

thereof. this does not include services or supplies that are

determined by the company to be Medically Necessary.....Now I have a

reason to fight like hellllll....

Sorry for the bad word but now I know that, that WOMAN was just being

nasty.

(fighting for what I believe in)

Denied on 8-1-00 first letter

>>

,

Okay, this is good. Now you what the emphasis should be in your appeal--the

issue of medical necessity. Be sure and ask for Dr R's appeal letter! It is

DYNAMITE and speaks to the question of medical necessity brilliantly,

tailored to the particulars of your case. It also includes lots of info

about lawsuits that were won in just this kind of case. In my appeal package

I included my appeal letter, Dr R's and a letter from my PCP. Also the

pateint ed manual. Make your appeal very personal and heart-wrenching. Show

all the diets and other plans you've tried. Throw in your family history and

anything else that you can think of. Have a family member (hubby? parent?)

write a letter pleading for your life, saying that you have become depressed

and speaking to your shortness of breath, and any other health issues that

apply. Don't hold back--this is your big chance. Then get the name of the

person who will be reviewing your case and call them immediately. Be sure

and connect with them before they have the chance to put the rubber stamp of

rejection on your case. Good luck! Give 'em hell!

Regards,

Debbie in IL

MGB 8/10 Cigna (1st appeal)--BMI 40

Daughter (age 16) MGB 8/9 Cigna (3rd appeal)--BMI 45

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