Help with insurance letter!

I have insurance that covers lap-band surgery and when paperwork was submitted by my surgeons office they are now saying that I have to have a letter sent from pcp but he is not the one that has been doing my medically supervised diet but he does have my history from several years ago showing my weight gain and loss but he has already wrote a letter to the insurance company and the insurance clerk at the surgeons office is saying that it's not specific enough because they want to know weight gain and lossed and dates!! I don't remember every single date and I filled out what I did remember and what type of diets when I registered with my surgeon...I don't know what else they want!! by the way I have bcbs of tn...any help would be appreciated!! Thanks, Jen in TN

Jen, Think about the request from BCBC's point of view. A person can put anything down in their diet history section of the surgeon's form. If you have not already done so, provide BCBS a letter from the person that has administered your medically supervised diet, to include BMI, duration and weight lost. They should have all the information that the insurance clerk had in their files. Your PCP would have recorded your weight at each of office visits and his/her notes would indicate whether you talked about your weight, exercise programs etc. Again his/her letter will confirm the amounts of weight lost or gained. In addition your file will contain comments on co-morbidities, etc., which would only strengthen position with the BC/BS. This information is also important to include in the PCP letter of medical necessity. Having the information from the person overseeing your medically supervised diet/exercise administrator as well as a letter of medical necessity from your PCP confirms, from two independent and reliable sources that the facts that the surgeon submitted to BC/BS are true. Information and knowledge is power... the more detail that you can provide the insurance company from independant sources, teh more likely it will be that you will be approved. Yes, it's a hassle and sometimes I think it's the insurance company's way of delaying the process and perhaps having people abandon there request to have the procedure being covered. Hang tough, ask the appropriate people for their letters proving your weight loss attempts and need for this particular procedure, and you will triumph in the end. [It's much easier said than done... Patience is not my strong suit either] Barbara, Terrell, TX