[sfmcfar]

Kim,

make the sure the plan documentation doesn't have the definition of investigational and experimental in it already - I know the my MAMSI plan has it listed in their defintions. Also search your plan's webiste - sometimes they'll have a list of definitions and include "investigational and experimental."

And if they don't send you a definition, maybe you can use that against them as well. Explain in your appeal that you requested the plan's definition, and never received one, so you'll have to apply your own definition...