Anyone have a sample PCP "medical necessity" letter?

Sharon T - PA · February 23, 2005

When I went to see my PCP last week, he gave me a prescription card that states "morbid obesity and joint pain". I've spoken to the Banding doc office and they stated that I need more than that - although since I don't get to see them until Friday, I don't really know what to request from the PCP. (they didn't give me a lot of detail about what should be in the letter - only that the prescription card isn't good enough...sigh)

I'd like to draft something then drop it off at the PCP office, hoping he'll put it onto letterhead and sign it.

Part of the problem, I think, is that he gave me a referral to the weight loss clinic within the health system - I can't even get a consultation there until May - so I'm sure he thought that would be enough.

Ok, long winded enough. Can anyone help? You can send me a PM if you prefer. Thanks.

the best me · February 23, 2005

Ooooo, something like that would be handy to have posted here! I'm sorry, I wish I had one, but someone out there has to!! Anyone?

lapbander081004 · February 24, 2005

Sharon,

My PCP gve a very simple one and it was accepted.

He simply stated

Greg has been under my care for 15 years during which time he has been overweight. He has been under my care in an attempt to lose weight and has not been successful.

Many of his other health problems are a direct result of his weight.

I feel as his PCP that he wold benifit from the lapband surgery and the loss of weight that wold result would help in the maintanance of his other health issues.

Not sure on the eact wording but it was very similar to this. I don't think I ket a copy of the letter but if I did I'll let you know and I can fax a copy to you if possible or Il send it word for word in an e-mail.

I'll let you know if I find it'

March 5, 2005

My Dr. wrote a letter that stated my age, weight and height. She listed my medical problems that were associated with my weight and made a mention of my most recent weight loss attempts, dates and method and the results. She She then stated that she felt that I would be an excellent candidate for the Gastric Lap Band procedure and that she was encouraging me to proceed with the Band.

Hope this helps

TrishS · March 5, 2005

My PCP hated the fact I wanted WLS He did everything to me aganist it... and for once.. i was able to go behind HIS back and get it done... got approve from Ins... everything i didnt need him at all.... I didnt need him saying that im taking the EASY way out anymore.... I did this all i my own with hard work... the more you want the better it will be Good Luck with everything Take Care