<prompt> Human: My SO was having recurring health problems from 2010 that became more frequent and more intense through last year before her surgery: Nausea, vomiting and abdominal pain that would worsen over the course of several hours. A handful of ER visits and consultations led us to a surgeon who had gone through precisely what my SO had, and she recommended removal of the organ immediately. Her episodes stopped completely. She obviously still gets nausea from time to time, but its never the violent episodes that required medical intervention. It should be added that she has a handful of family members who have also had the gall bladder removed and saw a significant QoL improvement in the months after.Now over a year later, Blue Cross Blue Shield has decided that the surgery wasnt necessary and she will be required to pay 12,000 for the surgery. What can she do? Any insight is appreciated, thanks.  <response>: Appeal the denial and then, if that fails, immediately start the external review. Call the insurance company and ask them for the process of:Appealing a denied claimStarting an external review of a denied appeal 