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Letter of medical necessity.....

Shellyin KY

By Shellyin KY, in LAP-BAND Surgery Forums

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Shellyin KY    0

Shellyin KY
Posted

This is all so new to me as I begin my journey. I understand what a letter of medical necessity is and why I(or my insurance) would need one. But my question is what should the letter contain and who should write it? Or do these surface once the battery of tests are complete by the doctors that I see???

Thanks in advance

Shellyin KY :confused2:

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lafrogura    0

lafrogura
Posted

I haven't had a family physician for the past 6 years or so but i have gone to the gyno every 6 months religiously for my entire adult life. So i had my gyno doc write a letter that said since i've been seeing her, which is only for the past 6 years, what my weight range has been for that time - whether or not she recommended lap-band for me and what the outcome might be for me if i did not have lap-band. My doc sent that to BCBS with my weight watchers info (my weigh in stickers). The surgeon sent a letter also recommending me to have the surgery based on my exam and consult with him. In 3 business days, it was approved. NO questions asked. But the pre-requisites from BCBS were 6-month physician supervised diet, psych consult, nutrition consult. I did have the psych and nutrition consult but no physician supervised diet and they still approved it. I have BCBS of Texas PPO. I get banded tomorrow.:party:

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poohprecious    0

poohprecious
Posted

This is all so new to me as I begin my journey. I understand what a letter of medical necessity is and why I(or my insurance) would need one. But my question is what should the letter contain and who should write it? Or do these surface once the battery of tests are complete by the doctors that I see???

Thanks in advance

Shellyin KY :confused2:

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Hi Shelly to be very honest I wrote my own letter because I moved to Texas and the last time I saw my PCP was in 2005. Someone on here sent me a template and I tweaked it myself. I could send it to you if you want me to....just send me your email. Honestly, I wasn't sure if they was going to call and confirm but it was my only chance I don't have a PCP here in Texas. I was approved in two days (June 30th)..........I will help as much as I can:)

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