Question:
PCP does not approve of this procedure therefore he will not help me with a Letter of

medical necessity. Should I ask my sleep doctor for help or a letter? He told me that if I would lose weight this would help with my sleep apnea and other related cormorbites? I see an attorney tomorrow, need all the suggestions I can get. Thanks in advance for all your help.    — CINDY D. (posted on May 28, 2003)


May 28, 2003
You can try the sleep Dr. but I would also just get a new PCP. You don't have to stay with a Dr. who is unsupportive and its no big deal to change PCP's.
   — Kris T.

May 28, 2003
You really do need a supportive PCP. Your PCP will be the one to monitor you long term. He/she needs to be willing to work with you and your surgeon to learn what to look for long term with you. If you like your PCP try to educate him on wls, take information to him, write a letter explaining exactly why you want wls. It has worked in the past for others. If not then I suggest looking for a new PCP.
   — TheresaC

May 28, 2003
I would find a new PCP. If you have a surgeon in mind, call his office to see if they can recommended a WLS-friendly PCP...JR
   — John Rushton

May 28, 2003
I told my sleep doctor first that I wanted to have WLS. He was very supportive. I asked him if he would write a letter on my behalf and he was more then happy to do so. I then went to my PCP and told her that I wanted to have WLS. I also mentioned that my sleep specialist agreed to write a letter. Right then my PCP became supportive and agreed to write a letter.
   — S A.

May 28, 2003
Cindy, I would ask your PCP why he dont approve or support your decision, and then I'd find another PCP, if this is what you want and you qualify for it, find someone that will support you.
   — Melissa Sanders

May 28, 2003
My PCP was left completely in the dark about my surgery. Didn't need him for anything. My surgeon group has their own internist they send you to. He clears you for surgery and orders your tests. The surgeon sent a letter of medical necessity to the insurance. If my pcp even knows, it is only because they sent him a copy of my discharge summary from the hospital.
   — Delores S.

May 28, 2003
I agree with the others who suggested that you find another PCP who will support you. A letter of medical necessity from your PCP is very important to your insurance approval. You want that letter to be written by someone who is behind you 100%.
   — Bonnie

May 28, 2003
I went through this with my PCP. She didn't want me to have it because of hypothyroid(thought it would make me a bad candidate). I let it go for a month with her. During that month I made an appoinment with the surgeon, and my lung doctor. Both said I would be a good candidate. I went back to my pcp armed with information, explained to her what the other two doctors had said, I also explained that I was an adult and that it was my decision and that if she did not support me with it I would fire her and get a different doctor that would. Two weeks later I had my letter of medical necessity. Some doctors just don't understand this surgery or think that you made the decision because you think it will be a quick fix. Make them understand or find a different doctor that will. Good Luck Nancy-waiting for surgery date.
   — Nancy S.

May 29, 2003
I get so mad when I hear the problems that people have with their PCP's regarding this! It is NOT their decision and you are not asking them to approve or disapprove it. You are asking for a letter of medical necessity. If he/she doesn't want to say in the letter that he/she thinks you would benefit from it, then they can simply put in the letter your health history and how it relates to your weight. They can list everything from simple co-morbids (such as pain in the feet and legs and stress incontinence) to major problems (such as diabetes and high blood pressure). If your doctor will not do this, then you should find another doctor, who, even if they don't necessarily jump with joy and clap their hands over it, will at least support you in your decision to move forward. Get your records transferred to the new doctor and he/she will have all the necessary information to write you a letter showing medical necessity even if they haven't been your PCP for a long time. Good luck to you!
   — Lynette B.




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