Family Physician or Lap Band Doc

[beachgirl 2]

Sorry to keep asking so many questions but I really need your help. My reg. doc has referred me for the lap band and I have a 40.4 B.M.I. and Anthem is suppose to take care of this according to the lap band doc but who do I get to write to the insurance company, my regular physician or the lap band doc and do I go see the lap band doc first or do I do this before I go.

Thanks for you help,

Sherri:help:

[Wheetsin 714]

Your insurance company can tell you who the letter (are you sure it's even required?) would come from. If your coverage requires a referral, then typically the letter of medical necessity would come from the pro in the particular field, not the internist/PCP. A friend of mine just had her PS covered by her insurance, but she had to have the letter come from the PS, not her PCP. With that said, my knowledge of how insurance works is pretty much limited to what the people at work share with me (I work FOR an insurance company, but do not work with insurance), and there are bound to be differences.

[wavydaby 1]

In my case, my PCP had to run all of the tests and write a letter of "ok for surgery and why". Then he gave it to my lap-band doc, who inturn, sends it to the insurance comp.

[gentlespirit 1]

My PCP wrote a letter of support for the surgery "To Whom It May Concern"; then my lap band surgeon included it when he wrote the letter of medical necessity to the insurance company.

Emily

[juliek 0]

It was my experience that the surgeon will tell you everything you need to gather for insurance. In my case, the letter came from my primary physican but the surgeon included it in the packet to the insurance company.