Question:
where can I find a sample letter to the insurance co . (Aetna)

I'm trying to write a neccesity letter to my insurance co. (I have Aetna). I don't know what I'm suposed to write, or what they want's to know. Can anyone help?    — loser2b (posted on September 10, 2006)


September 10, 2006

   — BigBear225

September 10, 2006
If you would like a copy of my appeal letter I would be glad to send it to you. I also have BC/BS. You are would come to make any changes needed. My email is [email protected] Laural
   — Laural D.

September 11, 2006
In addition to what Barry provided you in his letter, I would also suggest that you obtain copies of your medical records from your current and previous doctors demonstrating the issues that you endure as a result of your being overweight. Most states have laws on the book that require providers to provide with medical notes associated with your doctor's visits. Also, do some research and present the findings of your research along with your letter of medical necessity. Doing so further predicates your knowledge of what is going on and how the procedure will affect your life. On a separate note, I like how Barry's letter used a "what's in it for me?" line of logic. In other words, he presented in his case that authorizing the procedure would not only benefit his health, but it would mitigate future costs for Blue Cross/Blue Shield, which is an underlying thought that health insurance companies have when looking at claims. Health insurance companies are concerned for your safety, but they are also in the business of reducing costs.
   — Xavier Smith

September 11, 2006
Thanks so much you guys! Great info, I will use what applies to me. Teresa
   — loser2b

September 12, 2006
I have Aetna. I suggest that you go to their website, lr call and get their clinical guidelines for bariatric surgery. That will tell y ou what you need to do to get approval. They have hoops you have to jump through. You have to have documented (by a doctor) attempts at weight loss. (I think foir six months) you also need to have some comorbidities, such as sleep apnea, high blood pressure, diabetes, etc. You need letters from the specialists who treated you for thsoe diseases. Good luck!
   — Novashannon

September 13, 2006
Theresa if you send me your e-mail address i can send you a copy of a great sample letter. Good Luck in your journey Dawn :)
   — drunyan

September 13, 2006
sorry I forgot to give you my e-mail address: it is [email protected]
   — drunyan




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