PCP Letter to Insurance

bandmeplz · February 10, 2007

Did anyone see the letter their doc sent to their insurance company referring them for surgery? The reason I'm asking is because I have no co-morbidities according to my insurance - I do have a very bad back, a bad knee and a family history of heart attacks, high blood pressure, diabeties, stroke, etc that needs to be brought to their attention. My doctor said he would help in any way he could do you think putting this info in the letter would help? It couldn't hurt right?

Also has anyone included a personal letter with their submissions? If they could get a personal view on why surgery would help me I think it would be a help too.

What do you think? I do not want to be denied. :help:

cal · February 11, 2007

i can only relate what happened with my insurance.

First PCP letter was not "good enuff" so he had to write another one including my six month appts. with him. Had to included my weight for the month, kind of diet i was on, (calories), what had worked for awhile and what didn't etc. i wrote out a letter with all my operations, physical problems and my PCP included these things in his letter.

i also wrote my own personal letter....stating my reasons for wanting lap over gastric, meds, ANY info that would pertain to my "whys". What helped me a lot was the fact i had/have hypertension, arthritis, and had some invasive operations in the past...and didn't need anymore.

cal

maltomeel · March 11, 2007

I had my PCP wirte a "form letter" that my surgeon supplied as well as a second letter with the 6 months of very basic information on monthly weigh ins (by date), diet journal discussuions, exercise discussions as well as "patient frustrated with rate of weight loss, etc.). I also had my wellness Dr. (chiropractor/nutritionist) write a letter of support and did write my own story...in human-to human terms. Welss se if it helps. I have my sleep apnea study on Monday and when the results are back, I'm ready to submit. It hasn't been long since I began my journey, but it has certainly consumed my life from the start. Thank goodness I have unlimited access to a fax machine and copier at work!

Jill in NY

BMI 41

Dr. David Mayer, Huntington NY