need help ya'll!!

ok I went to see my surgeon and he said in about 4 and 1/2 months I will be done with all the hoop jumping for ins and he will then do surgery. Now what i need is a sample letter of necessity to give my pcp some ideas. anyone got any ideas? thanks A

There is a place here on OH that has letters...it may be under insurance help in the forums section. Try there and good luck!

April, I hope this helps.... You may be required to start with your primary care physician. In some cases, he or she is the only one you can ask for a referral to a qualified bariatric surgeon. Even if you are not required to get a referral, it is a good idea to have the support of your primary care physician. Before visiting the bariatric surgeon, organize your medical records, including your history of dieting efforts. They will be valuable documents to have at every stage of the approval process. Document every visit you make to a healthcare professional for obesity-related issues or visits to supervised weight loss programs. Document "other" weight loss attempts made through diet centers and fitness club memberships. Keep good records, including receipts. If your bariatric surgeon recommends weight loss surgery, he or she will prepare a letter to obtain pre-authorization from your insurance company. The goal of this letter is to establish the "medical necessity" of weight loss surgery and gain approval for the procedure. The following information is generally included in the pre-authorization letter: Your height, weight and Body Mass Index and any documentation you might have as to how long you have been overweight. Simply describing your condition as "morbid obesity" is not enough. A full description of all your obesity-related health conditions, including records of treatment, a history of medications taken and documentation of the effects these conditions have had on your everyday life is necessary. A detailed description of the limitations your excess weight places on your daily activities, such as walking, tying shoes, or maintaining personal hygiene. A detailed history of the results of your dieting efforts, including medically and non-medically supervised programs, medical records and records kept of payments to and meetings attended with commercial weight loss programs. A history of exercise programs, including receipts for memberships in health clubs. Ask your doctor to include information from medical journals regarding the effectiveness of weight loss surgery, particularly information showing the control or elimination of obesity-related health conditions. I got this off of www.weightlosssurgeryinfo.com - check it out, they have other useful tools.... have a blessed rest of the day. Sonya