Question:
Preapproval letter...who sends?....

Mine and my husb ins co will deny my WLS coverage due exclusion on both...but I'm going to fight it and go through Lindstrom...But....Who does the letter?...I don't have a problem doing it, My PCP doctor said she would sign anything and the surgeon I'm thinking about doesn't want to bother cause of the exclusions...Should I just do it and have my PCP Sign? Do I have to say it's that particular Surgeon? Thanx    — Debora H. (posted on July 13, 2000)

April 4, 2002
Deborah, I went ahead and wrote my own pre-approval letter and got my wonderful primary care physician to write a letter of medical necessity for me also. I picked up the letter from her and included it along with my letter and my diet history and mailed it, certified, return reciept requested myself. The bariactric center I consulted with was first told that this was a covered benefit. When they checked again, they were told that it was not and that they did not want to be bothered by it again. Well, everything then came to a HALT!! The bariactric center told me not to try to appeal because there is an exclusion in my policy and that it would not help. Well, I decided that I would not take NO for an answer. My policy also states that they will pay for "medical necessity". My doctor advised that this is medically necessary for me in her letter because of my weight and health problems I am beginning to experience. So, my answer is DO IT!!! FIGHT FOR THIS AND DON'T JUST TAKE WHAT THEY SAY AS WRITTEN IN STONE!! I am waiting for an answer from my insurance, but then, it's only been 2 days since I mailed my letters. I will pursue this until I have exhausted all avenues. You have nothing to lose by trying!!! Good luck to you!!!
   — Mari T.