Getting a letter from your pc to give to your doctor.
Hello Everyone,
Did anyone have to get a letter from their primary doctor for surgery? I'm just starting out. I had 2 appt. in Feb. and Mar., the doctor put me on a 1500 calorie diet and Xenical and told me to come back in 3 months. Needless to say with 1500 calaories I was always starving and with Xenical I didn't want to leave the house. LOL Therefore, I failed (once again). So, I didn't go back. I have an appt. with my primary (Dr. Marybeth Cilento) on Dec. 12 and an appt. with a surgeon (Dr. Morris Washington) on Dec. 22. I have Cigna Insurance which I'm told is the hardest Insurance Comp. to deal with. I guess what I'm trying to get around is the 6 month diet history. Does anyone think that if I got a letter from my primary stating I was there in Mar. and back again in Dec.insurance Comp. would go for it. I'm grasping here I know, but I don't know if I can wait another 6 months. Thank you for any help anyone can give me.
LaVonn
Well I had to do the 6 month thing but I have aetna. I went to my primary dr for 6 months but they have to document that he counseled you on weight loss and that he weighed you. A dr's letter is no good there going to ask to see the dr's notes for all the appointments.Beleive me they want you to give up dont.
Harris
Hi,
I have BCBS. I had to go thru the 6 month program, diet drugs for 3 months.
I have started this fight for approval almost 1 year ago (Dec 17th is 1 year).
I went thru all they asked. Finally today I was approved.
I almost dropped. At the end, I was on Marida and I was taken off due to some serious side effects. My PCP wrote a letter to confirm my history, status and issues and it worked. I heard that a letter now from PSP does not work.
As you will here, hang in there, and it you will win the fight one day.
Hey LaVonn -- Cigna is tough, and probably won't budge on the 6 month diet history. What they are looking for is consitently seeing your primary for 6 consecutive months (without letting it surpass 30 days between visits) and showing that you are attempting to diet and exercise. Even after doing all that, you will still need a letter of medical necessity from your primary.
In fact, Dr Cilento is my primary too -- I have Aetna insurance, and had surgery back in June 2003. At that time, I didn't have to have the 6 month, but needed to show consistent efforts to lose weight thru diet and exercise consistently thru the previous two years. Dr Cilento had to provide a letter for me. E-mail me privately if you want more info.
Good luck.
Nannette
Thank you, Nannette.
I have an appt. with Centrastate on Dec. 22 to speak with the Dr. and also to put me on a six month diet and exercise plan. I was told that after finishing that six month program it should be easier to get an approval from Cigna.
I sure hope so. I started thinking about the surgery last year and then chickened out. Thinking I could do it on my own. LOL I really don't understand these insurance companies. If I could diet successfully on my own I wouldn't need to have the surgery. I could show my patient files for the last 15 years and they could see my weight history. Anyway, thank you again. If I need any other info I may take you up on your offer to e-mail you privately.
Thank you,
LaVonn
I started the "process" earlier this year and after three surgeons I finally found one that gives you a "road map" so you know exactly what you need. Yes, you need the letter and yes, it's probably a 6 month run. Yes, follow everything that is being said here as walking along side you I'm doing the same. I've had to purchase things and change things but whatever it takes I want my band and nothing is going to stop me. Don't let it stop you either, you can do this!
LaVonn,
Hello. I am Michelle Brennan and I am from Brick too! As a matter of fact my son, Daniel, is very good friends with Brittany Troncone. You must be related, your last name is not a very common one. Are you Brittanys Mom or Aunt? This is too funny... there are a few people here from Brick now.
Anyway, relations aside, I wanted to invite you to the Ocean County Weight Loss Surgery support group tomorrow night. We meet at Community Medical Center in Toms River from 7-9pm. It's a great group of people and we will all help you through this amazing, yet sometimes frustrating, weight loss surgery process. Tomorrow is our Holiday Party too, so it would be a nice time to come and meet everyone in a easy going and fun atmosphere.
I had my gastric bypass surgery on August 31, 13 weeks ago today! I am doing great, feel wonderful and very happy about the whole thing. It has changed my life. If you want to call me or get together, just hollar, I'd love to be a support person for you, and we are so close in the same town! You can call me at 732-920-0281 if you'd rather call than write.
Blessings on your journey and I hope to meet you soon.
Michelle Brennan