It's not a block wall, I have actually never lost a fight with an insurance company once i get fighting.
I am still not doing anything about my own situation because i am waiting on the Doc to see if he can rsolve it before I take the fight on myself.
If I have to do all that work, which is probable, I'll PM you whatever I send them so that you know how to do one of these $%&$#^@! appeals. I hope it doesn't come to that because they are a pain, but I'll bet that's exactly what happens.
Tips:
-everything must be in writing, the phone is just a stalling thing that they do because they know that if they don't get a written appeal within the specified number of days (45 for my insurance), you lose.
-The basis they are rejecting you on is a written policy of some kind. Have them direct you to the exact written clause under which you are being denied, and write your appeal. and provide documentation, specifically to refute that the clause applies to your situation.
There is a further level of appeal: there is a State regulatory Board. take it up the chain of command all the way.
Nice to know I have company! Not! I'm sorry you are having trouble too
Insurers in the U.S. must be spending way more money on their bureaucracies than on medical procedures! And they say that universal health care is too expensive??!!