HELP!!! How do I write an appeal letter

Ahhhhhh, I just wanna scream!!!! This journey to weight loss surgery has certainly not been an easy one.
I was denied by Aetna a few months ago for not enough clinical info/ no documentation of morbid obesity for 2 years. I've submitted docs from 2008 that show's I'm clearly obese.

Turns out they had my height 3 inches taller than I actually am. That and my current weight made my bmi below 40....That had me feeling some kind of way.

My doc did a peer to peer in which Aetna's director required me to do an additonal 3 months of supervised diet. (Those months flew by  )

I've completed the 3 additonal months only to be told that bt Aetna that my case was voided because the Emory Bariatric clinic should have filed an appeal instead of resubmitting the case. They said my provider should write an appeal.

NOW I'M BEING TOLD BY MY PROVIDER THAT I HAVE TO WRITE AN APPEAL LETTER ...How in the hell do I do that?

I would hate to think someone is passing the buck to me so I an make their job easier  o_O

I feel this is my last shot to prove I need this surgery. Any suggestions on how to write one?

Thats insane!!! Your clinical coordinator should be the one to write an appeal letter because they have all of your records that are needed to write it! I HONESTLY would call and speak to the manager of the clinic!

I agree!!! I thought that sounded a bit far fetched. I wanted to cool off before I called and say a few choice words that could mess me up. Thanks

Actually, I am pretty sure that an appeal letter would mean much more coming from you rather than your ppo. Just talk in the letter about the same stuff you said in this post (your height was wrong, etc), and explain why this is your last chance. If you have a family history of obesity, heart problems, cancer, etc. be sure to include that. Explain to them that you feel this is your last chance to lose weight. Use anything that you can think of to persuade them to give this surgery to you. Some of these things your ppo would know nothing about. I didn't have to write a letter of appeal to my insurance, but I did have to write a letter of appeal to the state when they tried to drop my son's health insurance. You just have to pour your heart out on paper. The letter will reach someone that (hopefully) has a heart. Also, remember that every insurance/plan is different and while some people get this surgery easier than others, you just have to roll with the punches and do whatever it takes to get this surgery. My insurance also didn't approve my surgery because they needed "more documentation". But now I am approved even though they didn't make me write a letter of appeal. You can do this!! Just don't give up!

Thanks Jolenesky, I really appreciate this. I was lost and didn't what to say, but it's on now, lol!!! I'm glad it all worked out for you and I pray it does for me as well....I won't take no for an answer.

Examples of appeal letters obtained by googling "appeal letter for weight loss surgery":

http://www.obesitycoverage.com/insurance-and-costs/pre-appro val-process/sample-appeal-letter 

http://www.ehow.com/how_5598404_write-appeal-letter-weight_l oss-surgery.html 

http://www.bariatric-surgery-source.com/insurance-appeal-let ter.html 

http://www.wlshelp.com/insurance-appeal-letter.html 

http://www.obesityaction.org/educational-resources/brochures -and-guides/oac-insurance-guide/sample-appeal-letter-from-su rgeonpatient-to-insurance-provider 

http://www.obesitycoverage.com/insurance-and-costs/pre-appro val-process/appealing-a-denied-request-for-bariatric-surgery -coverage 

I am thinking that if you look at some of these you can copy and paste them into a word document perhaps taking bits and pieces of each to make a strong case for yourself.  Make sure you write from the heart and let them know what you have been through on a personal level.  The hell that comes with being overweight and the ridicule you may have gotten from others.  People can be mean.  But the personal stuff like this should be perhaps one or two paragraphs at most.  The rest should present the facts and just the facts m'aam ... lol

Thanks Calking, I will most definetly look a these and use you and Jolensky's advice to write this letter. I really appreciate it.

Sorry about all of your troubles trying to get approved.  That has to be so frustrating!  I don't have anyything new to add that the others haven't already posted.  Just good luck and we are saving room for you on the losers bench!

Thanks so much, I appreciae your encouraging words.

I feel you!  I got help writing mine by the wonderful people here on the board.  I posted it in a blog on my page so you can read it if you want.  Hope it helps!