Question:
In the first letter you write to your insurance, what do they want to know?

My doctor is not exactly cooperating with me as far as surgery goes. He has pretty much brushed me off and just told me to write down a list of times I have dieted. From what I have seen here, the insurance company wants to know more than just that. Can someone please tell me everything they want to know? I would like my letter to be as thourough as possible so I can avoid having to appeal. Thanks    — [Anonymous] (posted on August 3, 2001)

August 3, 2001
Someone told me she wrote what her life is like as an obese person in our society. She also stated this is not about cosmetic reasons, but about living healthy and being with her loved ones. She just spoke from the heart. She spoke about her life expectancy if she does not have the surgery. Good luck.
   — angel C.

August 3, 2001
Do you need a referal to get a consultation with a WLS surgeon? If not, just bypass your PCP and go straight to the surgeon. The surgeon's office should be able to handle things from there (i.e. ordering appropriate tests, obtaining diet history, etc.) and submit a request for approval to the insurance company. If you do need a referal to see the surgeon and your PCP is not cooperating, then you may need to change PCP's (this is what I had to do). Remember, you are not asking your PCP for surgery approval. You are simply asking him for a referal for a consultation to the WLS surgeon. I would suggest not contacting the insurance company directly. Let the surgeon's office submit the request for approval. After all, they are the experts on what is required and what the insurance company is looking for.
   — Gina E.