Re: Preapproval process? Reply from DD

[Guest guest]

I had the same questions.

REGARDING INSURANCE APPROVAL:

I submitted my Form over the internet with a special comment

regarding contacting my insurance comapny for pre-approval. This

comment was not read by anyone at Dr. R. office, instead I received

via e-mail a copy of a pre-approval letter Dr. R. office

automatically sent to my insurance company. I had not supplied a FAX

number (unavailable to me) so after I got e-mail confirmation from

Dr. R. that pre auth letter sent, I called. Debbie said it would

have been mailed, but she didn't know when and had no way to check on

it because their computers were not linked up together. To make a

long story short, my insurance company finally received the letter

about 3 weeks later, but they denied the claim anyway.

Dr. R. office will automatically send a letter (or fax) to your

insurance company from the information you provide on your form, you

do NOT have to print them off and submit yourself.

REGARDING PERSONAL PHYSICIAN LETTER:

I called to ask Debbie if they sent out the Dr. letter (sample on the

site) and was told NO that I had to contact my personal Dr. myself.

It was confusing to me because of the way the sample letter on Dr. R.

page was worded and set up. It really looked to me like an official

letter Dr. R. office would send out and it gave no explanation as to

what we were supposed to do with it, etc. I didn't know if I had the

authority it make it personal, but I did.

I PERSONALIZED IT: I added a date, the personal name and address of

my Physician, addressed it to Dear (his name), and when the letter

referred to " your patient . . . " I inserted MY NAME. I also took a

yellow high-liter and hi-lited the sentence that he requires a letter

from the personal physician, and that he should give the letter

directly to me to include in my packet of information. " Otherwise,

yes I tweaked it to fit my circumstances.

Than I wrote a very short cover note to my Doctor, and included it

with the letter. In my letter to my Personal Physician I told him I

was being considered for the surgery that was literally a life and

death matter for me. I told him I was including a letter from Dr.

Rutledge, to him, explaining the surgery and I asked that he please

read a copy of MY LETTER to Dr. R. (the letter that I would include

in my packet to him) that I also included for my personal Dr. This

way, if he read my letter to Dr. R. he would understand exactly why

the surgery was essential. When I composed my Patient letter to Dr.

R. I had in mind that I would also give a copy to my personal

Physician and it would be used as an " educational tool " . It was 10

pages and stated much of the educational materials Dr. R. has in his

Patient Manual, etc. I worded it in a way that not to belittle my

personal doctor or make it seem like he did'nt know all the

statistics about obesity, but I really proceeded as if he knew

nothing. I stated it like " it is my understanding from my research

that . . . . " and " according to _________, it states

that . . . . . " then I would refer to the statistics, etc. so I

wouldn't insult my personal Physician. However, I assumed that he

didn't know anything at all, so I spelled everything out in detail.

Some of the information was also included in the sample Doctor letter

by Dr. R. but I thought it would be OK to duplicate some and just

reinforce the issue.

I also included the home page of Dr. R. giving a little statistics

about him, how many surgerires, etc.

I hand-delivered the letters (and copies) to my Doctor office. I

asked that his receptionist give him the envelope (which I marked in

big letters " URGENT " ).

It took 2 phone calls on my part to find out if he read the letter,

etc. but IT WORKED. HE WROTE THE LETTER TO Dr. R and ordered the

tests.

Hope this is of some help.

Dee

MGB 5/17

[Guest guest]

So you are apealing the ins decision? Do you have to do that or does

Dr R office?

Thanks so much.

> I had the same questions.

>

> REGARDING INSURANCE APPROVAL:

> I submitted my Form over the internet with a special comment

> regarding contacting my insurance comapny for pre-approval. This

> comment was not read by anyone at Dr. R. office, instead I received

> via e-mail a copy of a pre-approval letter Dr. R. office

> automatically sent to my insurance company. I had not supplied a

FAX

> number (unavailable to me) so after I got e-mail confirmation from

> Dr. R. that pre auth letter sent, I called. Debbie said it would

> have been mailed, but she didn't know when and had no way to check

on

> it because their computers were not linked up together. To make a

> long story short, my insurance company finally received the letter

> about 3 weeks later, but they denied the claim anyway.

>

> Dr. R. office will automatically send a letter (or fax) to your

> insurance company from the information you provide on your form,

you

> do NOT have to print them off and submit yourself.

>