I have to get a medical necessity letter.

[timmy.in.tenn 0]

My insurance requires a medical necessity letter from my doctor. Can someone share what their doctor wrote? Does he need to go into major description on why that I need a Sleeve?

Thank you

tim

[Tiffykins 673]

This is just a generic sample letter I found through google. Your doctor can personalize it for your specific health concerns, medication needs (such as NSAIDS, or other meds that need to be absorbed completely which RNY can cause malabsorption of some meds). Also include your weight loss attempts over the last few years such as Weight Watchers, Atkins, medically supervised diet/exercise, Nutrisystem etc etc.

Hope this helps:

Re: Ms. XXX (your name)

DOB: Your date of birth

Dear Sir or Madam:

I have been seeing Ms. XXX as a patient since April 29, 2005 and trying to deal with her morbid obesity with diet and exercise programs. With her medical problems and lack of success with any significant weight loss, I am referring her to Dr. Bariatric for weight reduction surgery evaluation. Ms. XXX's height is 5’5” and her weight is 282 lbs making her BMI 46. To my understanding this alone should qualify her as a candidate for the procedure. In addition to morbid obesity, the patient is suffering from low back pain, exertional dyspnea, bilateral lower extremity edema, and headaches. She has already tried numerous weight loss/exercise programs without success including physician monitored weight loss programs w/ medications as well as Weight Watchers Program and other noted programs. She also has a strong family history of hypertension, diabetes, and heart disease. I am respectfully requesting pre-authorization for bariatric surgery to include the patient’s benefits and coverage. We will send the accompanying documentation. Hopefully, Dr. Bariatric will be able to help her with your assistance.

Sincerely,

Doctor Name and Signature

Doctor's Practice name, address, and phone number

[timmy.in.tenn 0]

Thank you very much.

Tim:thumbup: