Question:
I need Help!!!!!!!!!!!
I am in the process of getting all my paperwork ready that needs to be be submitted to the insurance company.( Its quicker that way) My pshyc eval, letter from dietician, my pcp documented weight loss/referal. I need help in writting a personable letter to the insurance company from me about why I need the surgery. The sample letter on this site is good but not so personable. Can someone please give me advice on a sample letter to the insurance company. My date with my surgeon is May 2. I am truly counting the days down. — Big_Sassy (posted on January 22, 2007)
January 21, 2007
Why do you have to wait till May 2 to see your surgeon? My advice would be
to find another surgeon who will do the approval thing with your insurance
company. This is not something that you should be handling. The doctor
needs to create medical necessity.
— Sheri A.
January 21, 2007
Why so long a wait to get into your surgeon? Once I had my date to meet
with my surgeon I got all my paperwork together to take with me, which
included letters from all my doctors. I did not write a personable letter
to the insurance company. My surgeon then took care of all the paperwork
needed to get the approval. It only took a day or two after they submitted
the request for my approval and surgery was set up for 3 weeks after that.
It might be worth checking into whether another qualified surgeon in your
area can see you sooner and help you with your process.
— cherrylc
January 21, 2007
Whoa Big Sassy -- not too fast. Its great you have that information
already; however, you don't have lab work, the referral is for you to see
the surgeon and not to have the surgery; you don't have chest x-rays and
what's even more improtant, you don't have medical necessity from the
surgeon to submit to the insurance company.
How long have you been on a supervised weight loss program. The letter
from your PCP carries more wieght than that of the dietician because the
dietician is not a doctor. Let the surgeons office do what they do. They
have a person that deals directly with the insurance companies. They know
how to word and write the process to show medical necessity so that you
will be approved. Insurance companies are being more strict on approving
the surgery, therefore, to avoid any premature let downs, I suggest you
allow the surgeons office to do what they do best -- perform the surgery
and get people approved.
— the7thdean
January 21, 2007
All of the other responses are on the spot. But first and foremost you
need to check with your insurance plan and see what is covered with the
surgery and required as each insurance company is different. As someone
who did all the right and required things and had to have a lawyer step in
on my behalf writing a personable letter is not going to get them to
approve you. You have very strict guidelines to follow when submitting
paperwork for the insurance company. On top of everything make copies for
the appeals process. I still haven't thrown out my paperwork and it has
been almost 2 years. Insurance companies are a business not your buddy
when you know that you need something from them that they cover but are not
following through on and you have followed the requirements and are still
denied you will need to be willing to fight.
— 1968 Loser
January 22, 2007
I read a book called"weight Loss Surgery, finding the thin person
inside you", author Barbara Thompson. In it you will find sample
letters to the ins. co., plus alot of other valuable info for patients
having or considerong surgery. Try your local bookstore or online. Let me
know if you need more help.
— jlw0423
January 22, 2007
I found some helpful sample letters on this website:
http://www.theroadtothin.com/
— Patricia R.
January 22, 2007
I am going to a weight loss center. The dietician, psych, surgeon and ins
coordinator (sp?) are all in the same office. They have held my hand every
step of the way and made sure I did everything I am supposed to be doing.
They are submitting all the paperwork to my ins. co. and if I need to
appeal, they will do that too. You might want to find a place that has
more experience with these things.
— KristineMarie
January 25, 2007
I, too, had to write a letter in addition to all the other paperwork. I
was told just to write about the effect being so fat had on my life, and
how the surgery would improve my quality of life. Just write from your
heart - the insurance companies are not expecting the Great American Novel.
— Novashannon
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