Letter of Medical Neccesity

[Megbd 3]

According to my insurance they'll cover my surgery if the doctor sees it medically necessary. So which doctor writes my letter for the Insurance company. My PCP, the surgeon or both?

[DELETE THIS ACCOUNT! 12,703]

Your PCP has to write it because he has your medical records and history.

[Megbd 3]

So then after I see the surgeon and do my psych and diet eval then my PCP writes my letter? Or before I do my evals?

[DELETE THIS ACCOUNT! 12,703]

So then after I see the surgeon and do my psych and diet eval then my PCP writes my letter? Or before I do my evals?

Honestly, I'm not entirely sure. My surgeon's office handled the insurance requirement. They told me I needed a letter from my PCP, I got it and gave it to my surgeon's office, then they submitted it to my insurance. They handled all the psych stuff and everything, else too.

Can you just give to whoever is dealing with the insurance at your surgeon's office? I'd call and ask because it would make your life a lot simpler.

[jsws91 153]

my pcp wrote the letter, at the end of my 3 month monitoring... I was accepted in a week.

[B-52 7,113]

Both....PCP has to do a LMN and justification...he is the referring Physician....your Surgeon needs to do also since they are the once billing insurance and looking to get paid.

My office does this 100 times a day....so don't worry, you Surgeon knows all the Doc's needed because I'm sure they do this 100 times a day....and they're there to make money so they want you to get approved.

[☠carolinagirl☠ 18,721]

like mis said, and from my experience, my PCD has to write a letter to my ins saying i needed the surgery and why. (i wrote out my entire history with my weight for my PCD as a reference). my hub was military and we moved every 4 yrs so i have a big medical history...different doctors....but i made sure every detail was in there.......it may help you too.

[stept04 465]

My PCP did not have to get involved at all not even for a referral. So I don't know if it depends on your insurance coverage.

[lassie 247]

my PCP did not have to get involved, I was seeing the surgeon for about 6 months before he submitted the paperwork. hugs