Approval Letter...who sends?.....

My husb and I both have Regency Blue Shield and both have exclusions...I think I want to try and fight...I will prob contact Lindstrom when denied...but before I do I need to get denied....Who can send the preapproval letters to the ins cos...My PCP said she was willing to sign anything,...The surgeon I'm thinking about says don't bother but are willing to the letter for a charge...Can write the letter and have my PCP sign it for pre-approval..or does it have to be the surgeon..thanx

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