letter to PCP..feedback please

kimberly84
on 7/6/09 4:39 am - ME

Hi everyone, I need some help with this letter I'm sending to my PCP..could you give me your input..thanks.
As you know I have been in the process of having Gastric Bypass Surgery. I recently have been seeing Dr. XX  for a year and half. Last September he had sent out to my request for surgery to my insurance provider requesting coverage for the surgery. I was denied due to lack of documentation of a supervised six month diet. Upon his referral, I started my supervised diet with a registered dietitian and finished in June 2009. I called his office to set an appointment up with him to let him know that I was finished and had the required documentation to re-request for surgery. I was then referred to the hospital coordinator and she had stated that he was no longer doing the surgeries because the hospital had pulled the program.  A week later she had called me back to let me know that  she had resent my file to my insurance and I was denied by my insurance once again for lack of documentation. I took it upon myself to appeal the second denial with my insurance provider and was approved for the surgery within 3 days of the initial denial. I had called her back and she had told me that it was too late and there was nothing she could do regardless of my approval. I would still like to go ahead with this surgery, and am asking for a referral to the Eastern Maine Medical Center.

 

micbrook
on 7/6/09 5:13 am - Clifton, ME
RNY on 11/21/07 with
Sounds like you have everything you need i would   just add the names of the doctors and who you talked to   and ,mail it out.

 
 

  
 
 
 
 
 
 
lesamay
on 7/6/09 11:43 pm - Ellsworth, ME
Sounds good to me!! 
      
Starting weight 248/   Day of Surgery   218.4    / Current 210/ Goal 145  
6.8 CC'S IN A 11 CC BAND  
Most Active
×