PCP?????

Hey! I have a couple of questions. What is a PCP exactly? Would I have to have been going to this doctor along time to get a letter of medical necesity?? I havn't been to one of those kind of doctors in along time.  I need a letter of medical necessity and I have no clue what kind of doctor to look for!

PCP = "Primary Care Physician" - usually a family practitioner, could be an internist or occasionaly call themselves a general practitioner. The idea originated with HMOs. They were concerned about curtailing the high costs of specialists so they wanted you to see your PCP first for everything, and get his or her approval before going elsewhere. HMOs require referrals, SOME PPOs do too -  most PPOs, the new "high deductable" plans, and traditional plans don't usually require referrals. All may allow you to designate a PCP regardless. My guess is a PCP can provide the letter you are looking for, but maybe a bariatric surgeon would be better. A phone call is always good to clear up your particular plan's rules.

My surgeon requires a letter from PCP and will submit both his & PCPs letter to insurance for approval. I had only been to my Dr. (PCP) once before asking for referral for surgery & had no problem getting it. Good Luck, DJ

Thank you so much, that was very clarifying. I dont ever go see regular doctors, it was always first care or the emergency room. lol. So what should I go see a family doctor about? Maybe just a check up. Im trying to find excuses to go to the doctor but im pretty healthy right now.

Anytime you change Dr.s they do a "New Patient" appt. so it is actually better to do it now while you're not having a problem. Like you I don't usually go unless I have a good reason, but it will be fine to go in and ask for letter & get regular physical. Good Luck, Diana

Thank you soooo much!
You rock

youre main do.  Primary Care Physician just to make sure he or she is on board.

Unfortunately, not all PCP's are on board with bariatric surgery. You might want to tell this person at your appointment that you need "medical clearance" for bariatric surgery. You do not want to get the "you need to diet and exercise and go to weigh****chers" song and dance. You have already been down that road I am sure and do not need another doctor to try to put off surgery for you! And have them send a letter to your bariatric surgeon, your surgeon will forward to the insurance company with all the other papers. By getting "medical clearance" you will get a letter that states all of your other health conditions, your weight and BMI and that you are medically fit for surgery. It will fit all of the criteria for medical necessity. Bonnie 264/155