[Exhorter]

Ok so now most know they have said no to me about my surgery. I know that I need to appeal no doubt about that!!! But now here is my question do I put my trust in the doctors "STAFF" or what do I do?
I know that in one of Doc's post she stated I had to speak their language and I know there is a book that I can get that will help, but it won't help them if they are the ones who are doing the appeal. What if they don't know their language? I would think they should as that is the surgery they do. When I ask her today how often they get patients who are turned down she said "oh all the time" this is normal. WEll I want to make sure I have everything done right before the appeal goes to them again. How many times do I get to appeal this decision?

[MsVickie]

You should only need one appeal. Two is the max I think. When they appeal it the letter will come from your surgeon to there medical director. The nurses at your health insurance company wont have anything to do with the decision this time. You have had such a problem with the office staff at that office to begin with. I will say I don't like the fact they picked though your medical records and sent just 15 pages. OK think of it this way. If you were ever diagnosed with hypertension, diabetes, sleep apena, ect.......these are weight related. Edema, skin rashes, numbness, joint pain, those are related to. I know you feel the Dr's office staff should be trained on what to send......but as you stated this Dr. is famous, and he is very busy. If you feel your still not trusting the staff... call and speak with the office manager. You tell her what is going on and Im sure she or he will look into it for you. Keep fighting Donna. I just wish you didn't have to fight as hard as you are but your gonna have to. Craig The guy that runs this site had to fight to. I would look into purchasing his book on line and giving it a good look. If your denied again.,......... I wont know what else I can suggest to help you. All I can do is suggest and lead you on what I know. The Drs letter will be the key to your puzzle in your situation.

[Kenyar]

I think you should trust in yourself. WHile the dr's office will be the ones writing letters and speaking with the ins companies, KEEP COPIES OF EVERYTHING. follow up ON EVERYTHING. make yourself seen and known by all parties. If you have to call weekly or daily to follow up do so, also it might not hurt to write a personal cover letter type of document when you re-submit your documentation for your appeal. Dont just leave it in the dr's office's hands. Please please please dollow up and dont give up.