Called Insur.-- Oh the questions I still have! Help me. please!!!

Hello all.. Happy Tuesday.. Gosh I can't wait to get this surgery done.. The idea of having energy again.. It excites me!!!! Anyways. I called insurance today and got this long ole list of stuff I have to have on the letters from the surgeon : Dr. Gupta, and my referring physician, and the psych eval. I'm sure that St. V and Dr. Gupta know all this stuff has to be on the letter but I thought I'd check with the wisdom of the many (that's u guys..) From Dr. Gupta for Anthem Blue Cross Blue Shield --Blue Access: History of Recent Physical Initial Consultation including a copy of office notes Document of Diets Current heigh weight and bmi Copy of Pysch Eval Nutritional Education Letter of Medical Necessity with codes Procedure, codes, and verbal description Is that why they gave you from St. V's??? And,, when I do the Pysch Eval, how long till we get that documentation???? Thanks,,, A Very Confused - Heather PS: Sherri,, I did like Dr. Gupta alot!! She really seems to be a matter factual surgeon and very sure of herself!! You were right.. of course..

After your intial surgeon evaluation, in about 2 weeks you should receive a letter from Dr. Cacucci to send to the insurance. So there is one. When you do the psych. evaluation you will get another little paper to send. If you check out my profile, I have a copy of the letter my PCP wrote for me. It is a great letter. I just sent a blank one to my physician and asked her to fill it in. Once that is received, you can send that in. I was approved in 2 weeks and primarily because of the great letter from my PCP. Hope that helps! Sam

I'm hoping to get a good letter from my PCP,, but I've only been goign to her for a year.. So I am a little nervous if I'll get a approved based on the limited information she has!!!

Hi Samantha, Where do you find the insurance codes for the different comorbidities? Thanks in advance. Hugs, Trish

My doctor actually plugged those in herself. So I have no idea! Sorry Sam

Patrice, Im not Sam but u get them off of your drs paperwork when they send it to you or u can call any medical office or pharmacy and maybe if u are lucky they will help u out. I know you can get them off of insurance papers too. The book they come out of is call a DSM I just dont think the average person unless u work in the Medical field has access to them. Its not something that u need to put in your letter. If u need a specific one I can get it for you at work but I dont go back for 2 more weeks. Email me if theres one u need. Or I could look up my paper work from when I submitted mine and see if I would have it on mine Mariah

Heather, I wouldn't worry about the content of Dr. Gupta's letter. Anthem had no problem with the one she did for me. It took a little longer to get the psyche letter than it did hers. Along with the stuff you have noted, I also included: Weights for minimum of last 5 years (my old pcp had lost my records so I included a letter from my employers Employee Health from physicals since my employ) Food/exercise journal for 6 months (Excel is great for this). I think it helps to include this to show the insurance that you are willing to work at this & keep track of what you are doing. (Email me if you have any questions about this) Cover letter...to further clarify and organize paperwork. I had organized the paperwork to where it was physician's letters grouped together, diets/pcp supervised diet notes, my journals, ect. I figured the easier I made it for the insurance to look over the information, the quicker they would make their decision. When you send in your packet, be sure to send it registered mail. Some insurance companies are real good at saying 'we never recieved it'. Also, be sure you make a copy of EVERYTHING for your own records just in case the originals do get lost in the mail. It took about 2 weeks for me to get the thumbs up. Good luck!! Sherri