LETTER MEDICAL NECESSITY NEEDED

Hi everyone! I now have a consultation scheduled for 12/26/03 in Ames with Dr. Bruce Hardy. But I need HELP!! My PCP has never written a letter of medical necessity for WLS before and wants me to write it and he will look it over and sign it. YIKES!! Can someone please send me a copy of one if they have one, so that I can use it to format my own? I would really appreciate it! Happy Holidays to you and yours! Sherry

Dear Sherry: Hi !! I read your post!!! Just my opinion, but I think your pcp should write the letter of medical necessity!! I'm sure he has written them in other situations. After all if it's because of medical necessity, he is the medical personnal, he should be stating why, as your pcp , he feels you need this surgery. He will probably need to describe any comorbidities you have, and send in any relevant office notes, pertaining to your medical situation. I have to wonder how behind you he is, if he's wanting you to do it for him. Also, you pay the office call fees, he's working for you!! I didn't mean to sound negative, if you're comfortable doing it, go for it, I guess it just didn't sound right to me. It may help your case more, if he writes it, and puts in some of that medical mumbo jumbo!! Best of luck to you, hope you're an offical pre-op soon!!!! DeeAnn R

Hi DeeAnn! I understand where you are coming from, but my PCP has never referred anyone for WLS before. I spoke with him about it, and about the example letters on this site, and right now, we both feel that I will be better able and more knowledgable about the surgery to advocate for myself. He is helping me with medical terms for my conditions and so forth, but the rest I feel, if I write it myself, will create more of an urgency for the surgery. Thank you so much for your input! Blessed Be! Sherry

Hi Sherry! Thanks for not taking offense at what I wrote! It sounds like you and your pcp are working together, that's good!! I guess this will be a learning experience for both of you! Is he pretty supportive of WLS? It really helps when your pcp is in your corner. A lady I work with, went to her pcp for a referral, for wls. She, like most of us, has battled obesity for years, and has several significant comorbidities, but he would not write her a letter requesting the surgery approval,as he did not support WLS. Needless to say, she has switched Drs! I was initially denied, but have appealed, and am awaiting the decision from the allmighty insurance company I've had so many ups and downs emotionally, trying to get insurance approval. I was denied intially, for not having a six month medically supervised diet. I have been seen plenty by my Dr over the years, for weight related issues, and always went to him before joining the various weight loss groups, so we're trying to get them to accept all that. All I can say is best of luck to you, and hope you're approved soon!! I'm hoping for an early Christmas present, an approval!! Take care, and happy holidays!!! DeeAnn R.