Question:
I heard there was a form letter on this site that we could use.

I heard there was a form letter that we could re-write and get our doctor to sign, to speed up the process in getting approval. I can't find it:(    — Maria J. (posted on June 28, 2003)

June 30, 2003
Here is what I found. I have re-written it to take along as a guide with my PCP since I am in the infant stage of finding out if RNY is right for me. (I HOPE I QUALIFY!) There really is a lot of help and advice on the site...you just need to surf, surf, surf! :) Good Luck and God Bless, Stefanie http://www.obesityhelp.com/morbidobesity/m-ins-lettermn.phtml
   — Stefanie B.

June 30, 2003
I have a couple of letters that I used and email to people all the time. One is a letter to your insurance company explaining why this procedure is medically necessary. You have your surgeon send it to the ins. co. along with your request for pre-authorization for the surgery. The other letter is one that I typed up for my doctor. I left enough room at the top for them to copy it onto their letterhead and used his signature block at the end. All they had to do was copy it and sign it and I gave this to the surgeon's office also to send along. If anyone wants these letters, email me and I'll email them to you. Good luck!
   — Lynette B.

June 30, 2003
Actually, here's the letters for your doctor to sign. If you want the letter to the insurance company from yourself, email me and I'll send it:<p> Here's the two that I had my family doctor and my OB/GYN copy and sign. If you want the other one, just let me know: <p> To Whom It May Concern: <p> This letter is regarding Xxxx Xxxx Xxxxxxxxx. Mrs. Xxxxxxxx is motivated, educated, and able to understand all aspects of surgery, recovery and long-term follow-up. She has been a patient of mine for several years (March, 1994 to present) and we have discussed her obesity as it relates to her health. In March, 1994 her weight was 242 lbs. and it is now 290 lbs. At 5'6" tall, her BMI is 48.4, which classifies her as morbidly obese. She has kept a weight loss/gain record of all the different methods of exercise and diet plans she has tried over the years. <p> Xxxx knows that her morbid obesity increases health risks and has expressed a desire to lose weight throughout the years, and in fact, every time she came in, I talked to her about that. I have talked to her in great detail about the harm that occurs from being overweight. She has tried many different diets and has gained and lost weight over the years and is now heavier than she's ever been. In the past, I have provided her with a 1500 calorie weight reduction diet, but without lasting results. Most recently she is reporting shortness of breath on exertion, pain in her knees, hips and back, fatigue, occasional reflux when lying down, and stress incontinence. <p> In the past, Xxxx had made emergency room visits related to chest pain and, after hospital admission and diagnostic testing was found to have a hiatal hernia. She is now reporting symptoms of sleep apnea and has been referred to a pulmonologist for consult. <p> She has a history of a high HDL/LDL ratio, bilateral lower extremity edema related to extended walking/standing (on 2 or 3 occasions, which resolved overnight), and migraine headaches. On her most recent visit of April 12, 2000, I notice that she was short of breath with speech, but she has been reporting some cough and congestion over the past 2 weeks, for which Vibramycin was prescribed. <p> Sincerely, Dr. Xxxx Xxxxxx, MD <p> And then here's the one from my OB/GYN: <p> To Whom It May Concern: <p> Xxxxx Xxxxxxx has been a patient of mine for several years and we have discussed her obesity during regular visits as it relates to her health. <p> During this time, Xxxxx has expressed a desire to lose weight and reports having tried many different diets, diet plans, and exercise ver the years without success, or at least gaining back even more than she had lost. <p> Xxxxx has been Amennorheaic for approximately 7 years directly related to her morbid obesity and bloodwork has been done to rule out pre-menopause. Of other concern, she has been unsuccessful at getting pregnant over the past 5 years due to her morbid obesity and has been referred to a reproductive specialist. <p> If you have any questions, please feel free to contact my office. <p> Sincerely, Dr. X. Xxxxx, M.D.
   — Lynette B.