Originally Posted by northerngal

I'm not sure if it's what you're looking for, I had to appeal my use of rituxin with anthem blue cross because they considered it to be experimental for cidp.
I appealed in writing first, when that did not work, we had a hearing over the phone with myself, a doctor , and 2 members from anthem.

If this is what you are looking for, then prepare yourself with facts regarding your condition, past treatments,and documented success with the drug/treatment you are trying for.
since the doctor on the panel would be a big part of the decision, I put him on the spot right in the beginning of the interview, by requesting his number of cidp patients and his experience with rituxin (both of which were zero, giving me an edge right off the start)
I also found that they tried to intimidate me with power, the fact that they were all there together and I was on the other end of the phone. If this is the case stand your ground and remind them that they too could find themselves in your condition one day, nobody wants to get sick and have to use our insurance. But, that IS why we have it. Good luck---if I can give you any pointers let me know.