Question:
Anyone heard of the doctor having to submit a Formal Request of Appeal?

After receiving two denials, I spoke to BCBS of TN today and they are stating I have to have my doctor call the Provider Service line and get information about a Letter of Reconsideration from my PCP has any one heard of this and if so do you have a sample letter? Desperately seeking help.    — Swalls (posted on October 4, 2006)

October 4, 2006
It sounds like they want your doctor to call so they can tell him what they are looking for. I think they are giving you every possible chance to get approved, but your doc is not providing the information they are looking for to show you meet criteria. So - get the number and see if he will call (or have someone in his office call) to get the information, so he can write a letter and get you approved. This is not something you necessarily need a copy of a letter for from someone else, as the insurance company is looking for something specific.
   — koogy

October 4, 2006
I got two denials from Aetna. My PCP called the medical director and argued the point and I was approved verbally, over the phone, then received a letter about 5 days later.
   — WMKaisla