[Texas-T]

This may be a touchy subject, but please hear me out....

I think during the inital phase of letter writing etc., it would be best to highlight those who meet the specific criteria outlined by the FDA without exception and are still denied coverage. This way the insurance companies have less ground to stand on. They can't argue that someone who meets the very specific FDA guidelines and has multiple doctors advising them to have the surgery should not have coverage. If we present 1,000 people's cases who have been denied, the insurance companies will focus on the FDA guidelines and I suspect, those who do not meet the requirements for one reason or another. This will deter focus from the 100's of cases who meet the FDA guidelines and are still denied. I think we can present our best case if we initally go about it this way. Everyone suffer's with this problem, but if we can get more ADR's approved for those who meet the requirements, then those who are exceptions in one or more area's will be more likely to be approved as well.

What do you think?