Question:
Has anyone had to go to the 2nd appeal to get a revision from Select Medical Manageme

I am in need of a revision. My pouch has expanded and the insurance company is refusing to pay. They are trying to make it look like I have done something wrong, but I have been following the diet and portion sizes the dr gave me after surgery. the insurance cut me off of my post op visits after a year out of surgery, and now after the first appeal..is saying that because I have no records from my surgeon after that time that they will not cover for me to see him now to even see if a revision is needed. The thought is that I have a restriction and therefore food has been staying in my pouch too long and has expanded it. I am wondering if anyone has had to go to the 2nd appeal with this insurance company, and what he/she may have had to put in the letter in order to get it approved. I am so frustrated right now. We found the problem because i have skin infections and need a tummy tuck, but have too much fat in my abdominal area to have the tuck right now. I have only lost 100 pounds since my surgery, wich is awesome on its own, but have been plateaued for over a year..and have gained back 20 in the past 6 months. Some is due to complications..and some is muscle since I work out 4-6 times a week. If anyone could help me..i would really appreciate it. Thnks so much, Anjonette    — AjAngelll (posted on March 15, 2006)


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