Letter to Insurance Co
On the advice of a friend who is an internist, I am drafting a letter myself, which is clearer than the letters he has done for me in the past. (including details of the type of diet, weight loss achieved,
I also spoke to the insurance coordinator for my husband's company (which carries our insurance) - they are waiting for the letter...
Wish me luck!
Pam
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To Whom It May Concern:
Ms. Podeszwa is a 26 year old female who has suffered her entire life with obesity. She currently weighs 235 pounds and is only 5'3". Her body mass index is at 41.7. The patient experiences shortness of breath, especially with mild to moderate activity, along with related asthma. In addition, she suffers from mild sleep apnea, unstable blood pressure with borderline hypertension, joint and lower back pain, early arthritic joint changes, pre diabetes mellitus and mild depression.
Ms. Podeszwa has tried unsuccessfully to lose weight. She has been on Weigh****chers, Atkins Diet, South Beach Diet, Zone Diet, Slim Fast, Fit America, 1500 ADA diet, and a variety of diet pills and supplements including: Zetacap, Dexatrim, Hydroxycut, Dudux, Stacker II and III, and One a Day Vitamin Weight Control pills.
Since Ms. Podeszwa has tried and failed at many weight loss programs and since her weight continues to go up, I have advised her to undergo laparoscopic gastric bypass surgery before she encouners more co-morbid conditions.
As the patients cardiologist, this letter is to further clear her for a cardiac basis for surgery. Her condition of cardiac arrhythmia is not a contraindication towards surgery. I personally have reviewed her most recent EKG and completed an in office echo cardiogram which were negative.
If you have any further questions, please do not hesitate to contact me.
Sincerely,
I keep asking myself what I will do if insurance is declined. I'll be angry for sure. 3 women at the same employer were approved, and they went to a "meat market" type of place with very little pre op counseling or support...while I have been actively involved in preparation for a full year!
Since reading the latest Oprah magazine, I am more convinced than ever that surgery is the best way for me to address my weight problem. At my consultation, Dr. P. said that surgery was the only long term remedy for obesity. I believe that is true. But what if surgery is not approved? Well...then I'll go back to the drawing board.
Did others of you have those kinds of questions along the way to approval?
I am a planner. If I know what is coming, I will plan for it. But right now, it's out of my hands for a while...and I don't like it!
but then, you are on the "other side" and you realize, you weren't waiting all that long....you were doing what you needed to do.
Yes...I had those thoughts, too. And I remember when I got my approval letter...I actually ran into the house estatically jumping up and down (for about 1 minute because I was then to out of breath) and shoved it at my husband and said (and this is supposed to meant in a happy tone....as I WAS happy) "I TOLD YOU I WAS FAT!! EVEN THEY AGREE!!"
The best thing you can do is continue to wait....and learn and soak up all the information you can. The more knowledge you have for the long road, the better off you will be. And if you are denied, there are appeal processes and what not which some have been successful at. Many times they will give you a clear cut reason for the denial...sometimes something as simple as one of the doctors forgetting to submit a weight history or something....if that's the case, it is just a matter of getting your documents reorganized and resending everything.
Pam
