Hi to you all. I NEED your help. My surgeon wants to send a letter from my PCP saying why he thinks I need VSG. Soooooo he ask me what do you want me to say. I know on here somewhere there was a "dummy" letter that someone had one here and it was kinda fill in the blanks kinda thing. And some of you are better at this than we are so will you please help me???? Thanks much. My surgeon will be sending all my info to the ins. company the first week in Sept, so it will be here in no time. THANK you all sooooo much.

Ask the bariatric coordinator, who usually deals with insurance approvals. They should be able to give you some info because they do insurance all day long.

Here is a copy of what I sent to the Surgeon. It is actually an outline given by their office at the information sessions.

August 4, 2010

To Whom It May Concern:

This Letter is a formal request for approval for Bariatric Sleeve Gastrectomy, for my patient _____________D.O.B______.

__________ is 5?5? and weighs 252 pounds. Her body mass index (BMI) is 41.9. She has been diagnosed with morbid obesity (CPT code: 278.01), since ____. She is having significant adverse symptoms as a result of her obesity. She is having difficulty standing and exercising due to the significant impact of the excess weight on her body. She has difficulty performing any daily activities and in participating with her friends and family in recreational activities.

She has been diagnosed with ____________________. The effects of these conditions are severe, and can be life threatening. Co-morbidities have proven to be expensive to treat and sometimes incurable. Research has shown that weight loss is not only cost effective for the insurers, but for the patients as well.

_________________ has made numerous weight loss attempts, including:

• South Beach Diet
  
• Weight Watchers
  
• Curves
  
• Transformations medical weight loss
  
• Michael Thurmond
  
• Certified nutritionist consultations
  

Based on ____________?s medical history, it is highly recommended she undergo bariatric surgery. In my professional opinion, it is the only way to improve her health conditions and significantly improve her lifestyle. If you have any questions or concerns, please do not hesitate to contact our office.

Sincerely,

MD

P.S. I was approved in less than a week.

Hope this helps,

Tracey

Here is a sample I had saved, it's for band, but you can change the wording to accommodate your needs. Also, include your weight loss attempts, behavioral changes you've made (parking further from the door, workout/exercise regimens, and other things that you've done to lose the weight on your own).

PCP Letter Head

DATE:

Dr. Paul Guske

ICO: Suburban Sergacal Care Specialists

4885 Hoffman Boulevard, Suite400

Hoffman Estates, Illinois 60192

RE: Patients Full Name

Dear Dr. Guske;

Currently, Mr. LAST NAME is a CURRENT AGE male who stands HIEGHT tall and weighs

CURRENT WEIGHT giving him a BMI current BMI. MR. LAST NAME is diagnosed as morbidly obese and all though currently in good general health, LAST NAME is fully aware of the health concerns facing someone of his size and his family medical history of Diabetes, Heart Disease, High Blood Pressure and other obesity related diseases. MR LAST NAME is concerned about his future as an obese adult.

Over the years Mr. LAST NAME has made several attempts to loose his excess weight using traditional methods including; Weight Watchers, Jenny Craig, Nutri System, Susan powder, Richard Simmons, Slim Fast, Metabolife, Atkins, Scarsdale, Opti Fast and others. This patient has experienced varying degrees of success with each of these plans but, to date he has not found any sustainable results using these traditional methods.

Mr. LAST NAME came to me in June of 2008 through a family referral seeking support as he was beginning the process of obtaining surgical intervention to aid him in his life long struggle over obesity. He was interested having the LaparoscopicBand procedure done and I offered my support. At the time of our first meeting Mr. LAST NAME weighed PRE DIET WEIGHT and had a BIM of PRE DIET. With the aid of a registered dietitian and Weight Watchers Mr. LAST NAME has made some notable strides in his latest weight loss effort. He and I agree that it is imperative that he continue on his current path of success. We also agree that in order for him to achieve sustainable results it is medically necessary for him to proceed with his original plan for surgery. He has expressed both a healthy knowledge of the Laparoscopic Band procedure and true expectations of what that procedure can offer him. Mr. LAST NAME has also demonstrates a knowledge of the weight loss process and seams committed to regaining control over his obesity. For these reasons I feel that Mr. LAST NAME is an excellent candidate for this surgery and could only benefit from the out come.

I am referring FIRST & LAST NAME to your service and evaluation for weight loss surgery.

Sincerely,

Referring Physician

Thanks Tiff......I also saw where you had UHC choice plan ins. me too. oing all I can to cover my you know what. How are things going for you since surgery?????

Thanks sooooo much for your help. Doing ALL I can to get approved.

Thanks Donna. What a process...