Question:
Has anyone done Appeal letter for surgery disapproval for lap band due to depression

I was just recently denied approval by Great West Healthcare insurance company for Lap Band surgery due to depression and anxiety stated on my psyc evaluation. I wish the psych counselor would have told me this before the request was sent to the insurance company. And they still have not discussed the results of the psych evaluation with me yet. I'm so agitated now. I'm currently working with my PCP on getting this diagnosis taken care of. Now I have to go and appeal the disapproval by the insurance company. DOES ANYONE HAVE A COPY OF AN APPEAL LETTER FOR THIS TYPE OF ACTION THEY CAN SHARE WITH ME?    — Johanna W. (posted on September 4, 2004)

September 5, 2004
There is a reason why they have these evaluations and it's important that you are truthful. This surgery is not easy. Along with the surgery comes emotion health issues and if you are already suffering from depression this will only compounded your already emotional state even more. Let me try to explain this as best I can. Think about the WHOLE diet industry. Why do you think diets do not work? Yes you can lose the weight but its the emotional part after you lose the weight that this industry has not solved so what happens... we lose, we gain, we lose, we gain. NOW think about this surgery.. this is not something that can be reversed. One you have the surgery that is it! The emotional part of this surgery is the most important and the most difficult to get a handle on. In a lot of cases we need follow up with counselors to get the emotional garbage out of our heads. If we don't we will go right back to our old eating habits and gain weight back! I would sit down with the psych and have along talk. Gook Luck to you.
   — Linda R.

September 5, 2004
Johanna, I'm with the other poster, this is a very serious decision and the depression needs to be addressed with a professional that deals with this type of diagnosis. PCP's can often prescribe anti-depressants, but that only masks the original issues. However, I have bipolar and at times have suffered from extreme depression - and I was still approved. I submitted tons of data that I was stable on my cocktail of meds, I had the support of both my pdoc and my therapist and I had a support group and individual therapy in place after the surgery. As such, the approved my case based on bipolar/depression being a comorbidity. So see - it isn't impossible. Show them that you are serious about the surgery and the toll it will probably take on you emotionally. I wish you good luck! God Bless, Barbie
   — BarbieCarroll