My PCP Won't Cooperate!!!!

I'm besides myself right now. I went to my primary physician today and explained to him that I needed a letter from him stating my weight problem and how long I've had this problem and what measures I've taken to try to lose weight. It has to be a formal letter, but he opted to scribble my weight on a prescription paper. I told him that he needed to include the things I've done to try to lose weight on my own. He told me he couldn't do that because he wasn't the one that had put me on any of the weight loss programs. I've been going to this doctor for at least 7 years and he knows me pretty well, and I was taken aback at the way he handled this. I distinctively explained to him that the letter was the only thing left in order to submit everything to the insurance company. Because I have Horizon, they ask that a letter be submitted listing everything I've tried doing to lose weight on my own. I took the crappy piece of paper to my surgeon's office and explained to the secretary my plight. She told me that the insurance company will not accept it and that it needs to be a formal letter. She said all they ask for is a letter stating my weight situation and that he's aware of my weight problem and my desire to have the surgery done. She said she's very surprised that he wrote that note on a piece of script paper when he's the primary doctor for many of the surgeon's patients and knows what needs to be done. I'm so disgusted and disappointed. I'm so close to having the surgery done and I've hit this darn road block. What should I do? Should I go back to the doctor and explained to him once again what I need from him? I've never been on any supervised diet program, but the insurance is not even looking for that, so I was told by the surgeon's secretary, all they want is the letter from the doctor confirming that I have a weight problem for a certain amount of time. Should I type up a sample letter for the doctor? I don't want to seem presumptuous and arrogant, but I do have an idea of what the insurance company wants. Nereida

I typed up a letter and my PCP signed it. I only had this PCP for 2 months. Your Doctor sounds like a real JackA$$. There's some sample letter on the forum somewhere. Just look around

Where exactly could I find a sample letter in the forum? I appreciate any help I can get. Thanks, Nereida

Go to top of page ...click on Home.....Then click on Learn.... Then click on ..Making the Choice You should really read as much as you can so you are informed..less chance of you insurance company turning you down. Good Luck

just type up a letter covering everything you have done in the last 7 years u have been his patient and then bring it to the office and have him sign it. include your weight, any diet plans you have been on, also any conditions u have that are weight related, especially if he has treated u for them, etc. if he refuses, call your insurance company and complain!!! be proactive, some doctors are just uncooperative unless pushed a bit good luck, jacki

Hi Nereida, I have Horizon BCBS and this is what i was told they need. A letter from the PCP saying he recommends the surgery.  The letter should include any comorbities I have and list what my weights have been each year for the past five years.  This is to show that i have been obese for at least 5 years. A letter from me saying what diets i have tried, the duration of the diets, the results.  Sort of a history of my inability to keep the weight off for any length of time.   I suppose plans within BCBS may vary, but my doctor doesn't know my dieting history and he definitely doesn't know it like I do.   Did you have to write a letter? Leah

Is your PCP in a group - if so - go to a different Dr. in the group. Type up the letter yourself - document EVERYTHING - ask for your records at your PCP's office - they are your records and you have rights to copies of everything.    If you've gone to specialists (coronary, respiratory, endocrine, etc.) - request records from their offices. Prepare a case -- it will take a little time -- but will be worth it. Yes -- write that letter --  be proactive. Worse case is you take those records to a different PCP and request their support! I consider myself lucky - I have a great PCP (an all woman practice - which I feel for me is a tremendous help!) -- who not only supports me medically - but who has become a true friend! Good luck! Adrienne

Hi Nereida, I would type up a letter myself and go back to my PCP and tell him that your not leaving until he signs it!!   I would not let anything stop me and you shouldn't either.  Good-Luck!!!! Melissa

Nereida, I wrote both the letter for my GBS and also the Plastic Surgery letter and had my doctor's office put it on his letter head. My plastic surgery letter is on my information page.  I also went to his office and asked him for my chart and pulled out the records needed.  His office then copied them and I submitted all that to the surgeon's office who did the rest.  Insurance companies vary but the most want a  record of how long and how many different diets that you have tried.  Amount of time may vary.  If you have gone to this PCP for 7 years you have the documentation.  You now have to take the bull by the horn and  get everyone moving.  The more pro-active you are the faster you will get results. I had to put in 7 calls to my PCP to just get a referral.  Managed Health care suck. Good luck to you. Jeanne

My PCP pulled the same stunt.  He wrote it on a script paper.  I got so mad I came home, typed up the letter detailing everything and took it right back.  He didn't want to sign it.  I told him if he didn't, he might as well just hand over my files because I WOULD find a doctor who would help.  In the meantime I told my surgeon's office what was happening.  They offered to fax me a sample letter so I would know what insurance would want. Your doctor does sound like a jerk.  What would make me angrier is that he is already a PCP with patients who have gone through this.  I was the first for my PCP so "maybe" he just didn't understand.  Yours is just being difficult.  Be proactive and do a letter documenting everything yourself. Good luck!  And, I'd find a better PCP if I were you.