Anyone Have Sample Letters that worked

My friend is sitting with a lap band that has 15cc in it and the doctor said he will do no more fills.  She has lost a  grand total of 25lbs since she got the band over a year ago and has o restriction and never has.  Her insurance will probably cover a revision but she has been waiting 2months for her primary care doc to write a letter saying she still has all the same medical probs etc.  She thought if she had a sample she could personalize it and get the doc to sign it and get things going. Thanks

Hi Cassandra,

Lots of questions here:

Is she planning to have the revision with the same surgeon who put her band in? Curious since he does not seem to be helping her either.

IF she does have a problem with the positioning of her band, why would she not get a letter from the surgeon rather than the primary care physician? I am asking because I am a revision from lapband to sleeve and my surgeon was required to write the letter. Typically, they dont need to see anything from the PCP since there is clearly something not right with her band and she does not need to qualify under the same criteria for revision.

FYI: My band surgeon is not the surgeon who did my revision. I had a revisional surgeon do my surgery since they are more qualified to get approval and have the experience to deal with revisional complications.

Babs

I dont know.  I guess we are just too dumb to have surgery.

Hi,

I hope you are joking because I was trying to be helpful, not hinder her progress. My point was she may not need a letter from her PCP if she is a revision since the goal of a revision surgery is to fix an existing problem with her band (which technically is not a revision but a repair) or to remove the band and revise to something else. If she is revising, the criteria is different than a virgin surgery. The goal is to fix the problem or complication which would be a non functioning band and give her the ability to lose weight with another tool. If her present band is fixable, then all she would need is a letter from her surgeon explaining what is wrong with the band and explaining why she needs to revise, fix or remove it.

Babs

Different insurances have different protocal. I did have to have a letter from my PCP and my revision surgeon. Plus 5 years of charted weights showing me over a certain BMI, all the original surgeons notes on the surgery I received in the 90s and anything else the insurance could dream up for me to provide. I also had to have a personal letter from me included, stating my understanding of the surgery, a phych eval, tons of tests and then almost didn't get approved until they 'felt' me take a big old deep breath. Insurance companies are a necessary evil and are given too much power. Okay, I'm done venting.....