Question:
Does anyone have a strong letter of need from PCP for difficult third party

administered insurance co.? There's an exclusion in my policy, but they approved the evaluation by the surgeon. Please if anyone has any good ideas to share!    — [Anonymous] (posted on August 15, 2001)

August 15, 2001
I don't have a "strong" letter of need. But I have an exclusion that I'm fighting right now. I was advised by someone in my HR dept. to make sure the letter stress that this is a "medical necessity" and not elective surgery. To get a letter of medical necessity from each and every specialist you have seen, and make sure you include a letter from yourself stating the medical need, and cost effectiveness. They want to see that they are going to actually be saving money by approving this procedure so if they think that your health issues are going to cost them more money in the long term than surgery - it just makes sense to cover it. I have seen where that doesn't always get you approved - but it can't hurt. Good luck
   — K T.