Question:
I need Help!!!!!!!!!!!

I am in the process of getting all my paperwork ready that needs to be be submitted to the insurance company.( Its quicker that way) My pshyc eval, letter from dietician, my pcp documented weight loss/referal. I need help in writting a personable letter to the insurance company from me about why I need the surgery. The sample letter on this site is good but not so personable. Can someone please give me advice on a sample letter to the insurance company. My date with my surgeon is May 2. I am truly counting the days down.    — Big_Sassy (posted on January 22, 2007)

January 21, 2007
Why do you have to wait till May 2 to see your surgeon? My advice would be to find another surgeon who will do the approval thing with your insurance company. This is not something that you should be handling. The doctor needs to create medical necessity.
   — Sheri A.

January 21, 2007
Why so long a wait to get into your surgeon? Once I had my date to meet with my surgeon I got all my paperwork together to take with me, which included letters from all my doctors. I did not write a personable letter to the insurance company. My surgeon then took care of all the paperwork needed to get the approval. It only took a day or two after they submitted the request for my approval and surgery was set up for 3 weeks after that. It might be worth checking into whether another qualified surgeon in your area can see you sooner and help you with your process.
   — cherrylc

January 21, 2007
Whoa Big Sassy -- not too fast. Its great you have that information already; however, you don't have lab work, the referral is for you to see the surgeon and not to have the surgery; you don't have chest x-rays and what's even more improtant, you don't have medical necessity from the surgeon to submit to the insurance company. How long have you been on a supervised weight loss program. The letter from your PCP carries more wieght than that of the dietician because the dietician is not a doctor. Let the surgeons office do what they do. They have a person that deals directly with the insurance companies. They know how to word and write the process to show medical necessity so that you will be approved. Insurance companies are being more strict on approving the surgery, therefore, to avoid any premature let downs, I suggest you allow the surgeons office to do what they do best -- perform the surgery and get people approved.
   — the7thdean

January 21, 2007
All of the other responses are on the spot. But first and foremost you need to check with your insurance plan and see what is covered with the surgery and required as each insurance company is different. As someone who did all the right and required things and had to have a lawyer step in on my behalf writing a personable letter is not going to get them to approve you. You have very strict guidelines to follow when submitting paperwork for the insurance company. On top of everything make copies for the appeals process. I still haven't thrown out my paperwork and it has been almost 2 years. Insurance companies are a business not your buddy when you know that you need something from them that they cover but are not following through on and you have followed the requirements and are still denied you will need to be willing to fight.
   — 1968 Loser

January 22, 2007
I read a book called"weight Loss Surgery, finding the thin person inside you", author Barbara Thompson. In it you will find sample letters to the ins. co., plus alot of other valuable info for patients having or considerong surgery. Try your local bookstore or online. Let me know if you need more help.
   — jlw0423

January 22, 2007
I found some helpful sample letters on this website: http://www.theroadtothin.com/
   — Patricia R.

January 22, 2007
I am going to a weight loss center. The dietician, psych, surgeon and ins coordinator (sp?) are all in the same office. They have held my hand every step of the way and made sure I did everything I am supposed to be doing. They are submitting all the paperwork to my ins. co. and if I need to appeal, they will do that too. You might want to find a place that has more experience with these things.
   — KristineMarie

January 25, 2007
I, too, had to write a letter in addition to all the other paperwork. I was told just to write about the effect being so fat had on my life, and how the surgery would improve my quality of life. Just write from your heart - the insurance companies are not expecting the Great American Novel.
   — Novashannon