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[IP] Answer to SteimQuest and Sue Ann



SQ--Anthem of Virginia

Sue Ann--you wouldn't meet criteria and therefore would be denied.  
BUT, your doc could do a peer to peer and possibly get the decision  
overturned. Since I only do denial letters I have no idea how often  
these things get overturned.

Insurance companies really aren't the enemy and a know that a lot of  
this stuff saves money in the end but they are bound by contracts.  
Very often it would be cheaper just to approve something than go thru  
appeals (external appeals especially) so if there's compelling reason  
to approve something they do try their best to find a way to approve it.

Hope this helps.

Kelly
.
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