Insurance Appeal!



If you requested pre-authorization for weight loss surgery and receive a denial letter, Appeal. Then you can usually respond within a timely manner but effectively. You should become pleasant and polite when appealing. Cool down and keep in mind, your goal is “approval for weight loss surgery”. Your appeal letter should write in effective way including:

  • Patient Identification: – Letter must contain about your case, name, policy no., group number and claim no.
  • Reason for denial: - Briefly state about denial reason.
  • Brief history about health: - should be written history of obesity, present health condition, and previous weight loss procedure.




  • Information to correct errors: - if it appears a few errors were responsible for denial, restate the correct information like- procedure coding error or wrong surgery.
  • Why you oppose with denial: - Inform the insurance company why they denial your approval of weight loss surgery, whether due to incomplete information or fake information and then provide detailed, accurate information that supports approval.
  • Reason of letter: To insure and reconsider about the denial and approve coverage for the procedure in a fixed manner.




Here a few tips have been given for the Appeals Process

  • Keep copies of all letters you receive from the insurance company, consisting denial letter (s) and approval letter.
  • Make copies of all letters you send to the insurance company, including letters, medical files, health history and others documents.
  • Keep a written record of all meeting and phone calls with the insurance company.
  • Send all required documents to the insurance company through certified mail with return receipt.
  • Be determined: - It can take a lot of time and work, but don’t worry. Most of the people become successful in approval of weight loss surgery with determination and proper documentation.