HelenH48
New Member
- Joined
- Oct 17, 2017
- Messages
- 1
Hello, I started my VSG journey 02/2017. I completed everything required for my plan, paperwork was submitted on 09/01/2017 and according to my denial letter, which states "Not Medically Necessary , due to lack of medically supervised weight loss attempts" , in which I took supporting documents to my surgeons office, prior to them submitting request for approval, they denied the request on 09/01/2017 and I received the letter dated 09/12/2017 . My surgeons office says that they will file an appeals , but as of yet none have been filed. When I call the surgeons office and ask to speak to the insurance coordinator, I' m told that she is unavailable and she will call me back in 2 to 3 business days. When , if she calls me back, she has a serious attitude and says," she has forward all the paperwork," including other paperwork that I have taken to the office ,"to the surgeon, and there is nothing more she can do. I guess reaching out to him is beyond her means? What exactly is your job description? I so aggravated. First, my original surgeon, left the practice in 07/2017, so they added me to the new surgeon, and now I feel that they don't care about my appeal , because he have other patients who got their approval and I'm placed on the back burner. Help, what to do!!! I" m trying to get this done, by 2018, because my deductible has been met , and out of pocket costs will be cheaper .My care manager at Wellmark thinks I should file an appeal myself ,or seek help from another surgeon. Another surgeon is not an option , because it's a process trying to get into a program here in the Charlotte area and I feel they will drag their feet about releasing the paperwork in a timely fashion. I'm so lost I have no clue, how to write a good appeal letter, any help would be greatly appreciated. Thanks