VSG to DS: Denial Overturned! (See Doc to Help You!)

Stefanie S.

Well-Known Member
Before I get started here, I want to publicly thank @DianaCox and @Larra for all of the time (even at 6am!) they've so generously given me over the past few months in trying to get my insurance denial overturned. I am not sure how we got so lucky to get both of them here, but I am grateful beyond words. I love the bluntness, the extensive knowledge/experience, and the words of encouragement. I can tell you that when I got the letter on Friday that I was finally going to be approved, the reviewer used many of the exact phrases and arguments that Diana and Larra wrote for me. It is without doubt in my mind, that these 2 are a HUGE reason I am finally going to get my surgery paid for (the one I already had in January.) Neither of them would accept my offer to financially thank them, so once I get my insurance money, I will make a $300 donation to this site in their honor. What an amazing gift this site and these women are to all of us!

In an effort to pay it forward, I am going to attach the exact appeal letter that Diana, Larra, and I wrote for this final external review. I will attach it as a Word document so that you may download it, customize to your situation, and use it.

If you are in this fight, don't give up! I almost did. The insurance companies will wear you down. But I'm glad I kept going.
 

Attachments

Ellie Mae

Active Member
Before I get started here, I want to publicly thank @DianaCox and @Larra for all of the time (even at 6am!) they've so generously given me over the past few months in trying to get my insurance denial overturned. I am not sure how we got so lucky to get both of them here, but I am grateful beyond words. I love the bluntness, the extensive knowledge/experience, and the words of encouragement. I can tell you that when I got the letter on Friday that I was finally going to be approved, the reviewer used many of the exact phrases and arguments that Diana and Larra wrote for me. It is without doubt in my mind, that these 2 are a HUGE reason I am finally going to get my surgery paid for (the one I already had in January.) Neither of them would accept my offer to financially thank them, so once I get my insurance money, I will make a $300 donation to this site in their honor. What an amazing gift this site and these women are to all of us!

In an effort to pay it forward, I am going to attach the exact appeal letter that Diana, Larra, and I wrote for this final external review. I will attach it as a Word document so that you may download it, customize to your situation, and use it.

If you are in this fight, don't give up! I almost did. The insurance companies will wear you down. But I'm glad I kept going.
Congratulations and thank you for sharing this!!! Makes me feel even more blessed to be here...even though I know my desperation must be so annoying at times and I apologize for that!
 
Last edited by a moderator:

Ellie Mae

Active Member
Congratulations again! Anyone else reading this who is having a rough time with your insurer, know that 1) you CAN prevail, and 2) you may need to fight all the way through external appeal to win. So never give up unless and until you have exhausted all your avenues of appeal.
This makes me feel ready to fight!!
 

Stefanie S.

Well-Known Member
This makes me feel ready to fight!!
Yes! Definitely fight! I spent hours upon hours on each appeal. Don't take it lightly. Listen to Diana and Larra as they KNOW the right way to word things and provide adequate and proper documentation. BELIEVE in yourself and that insurance SHOULD cover it... then tactfully convey that in your letter and documentation. Best wishes!
 

Jojobanana27

New Member
Congratulations again! Anyone else reading this who is having a rough time with your insurer, know that 1) you CAN prevail, and 2) you may need to fight all the way through external appeal to win. So never give up unless and until you have exhausted all your avenues of appeal.
Larra, i have medical and live in California, Kaiser denied me, DMHC denied me and I’m in the process of getting a state hearing, what else can I do?
 

MsVee

Well-Known Member
Congratulations! Good health is priceless and we owe it to ourselves to fight for it. I am so glad you fought the good fight and won.
 
Top