A Personalized Letter For Insurance Approval [a template]

[MsJacquiiC]

I decided to write a letter on my own behalf to my insurance company in order to gain approval for my laparoscopic roux-en-y gastric bypass. It was not required, but it certainly could not hurt. So I insisted that the letter be included in all the other "official" paperwork my surgeon's office sent to the insurance company.

I thought I'd share it here in case anyone would need a template of sorts for their own personalized letter. Of course - the letter is a template... If you write a letter, it would be in your best interest to include specifics about your own situation.

I hope this helps someone, as I do believe it helped me get immediate approval from my insurance company.

Jacquii.

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To Whom It May Concern, I’m [YOUR NAME], a [YOUR AGE] old of [YOUR CITY/STATE]. I stand [YOUR HEIGHT] with my current weight fluxuating between [WEIGHT] pounds... I have had a history of childhood, adolescent and adult obesity. My current BMI is [YOUR BMI] which classifies me as [OBESE, MORBID OBESE or SUPER OBESE]. At [YOUR AGE] years old, my weight condition has not caused me any significant health problems except for high blood pressure, asthma, shortness of breath on exertion and some back & joint pain. I’ve thought about bariatric surgery over the years as a means to get my weight under control. In fact - After attending a few seminars, support groups, dietician classes and online communities for weight loss surgery (WLS), I’m quite sure WLS is the best option for me to get my weight to a healthy level and under control. I’m interested in having the [THE SURGERY YOU WANT] actually - and I’m most sure that surgery will be the preventative measure which thwarts any future health problems associated with obesity. I do understand the health risks associated with morbid & super obesity, as well as the serious nature of any WLS. Over the years I’ve tried several weight loss measures including diet and exercise, over the counter weight loss supplements, and meal replacements. Under the care of past physicians, I had also tried numerous prescription weight loss pills, including Fenfluramine & phentermine (Fen-Phen). Most recently I’ve completed a dietician-supervised program through [NAME OF YOUR 6-MONTH PRE-OP PROGRAM]. During this program I’ve followed the nutritional guidelines, but have found effective exercise difficult due to back and joint pain. All other attempts at significant weight loss have been unsuccessful, thus my need for the WLS. I have discussed my current health with a few doctors and agree that it is time for a permanent resolution to eliminate present and future health issues. And considering the success rate of bariatric surgery and the health benefits involved, I feel WLS is the best solution for me. Sincerely, [YOUR SIGNATURE AND PRINTED NAME]

NOTES:

1. You can use The Journey BMI calculator to configure your approximate BMI...
   
   
2. Be sure to list any co-morbidities you may have in the 2nd paragraph above...
   
   
3. List any and all "official" diet programs you have tried in the past in the 3rd paragraph above...

Body Mass Index BMI A statistical method of figuring out the degree of excess or insufficient weight based on one's height & weight. Though the controversial BMI does not actually measure the percentage of body fat, it is a useful tool to estimate a healthy body weight based on how tall a person is.

Bariatrics The branch of medicine that deals with the causes, prevention, and treatment of obesity. The term bariatrics was created around 1965, from the Greek root baro ("weight," as in barometer), suffix -iatr ("treatment," as in pediatrics), and suffix -ic ("pertaining to"). Besides the pharmacotherapy of obesity, it is concerned with obesity surgery.

Hypertension Also referred to as high blood pressure, HTH, HTN or HPN, hypertension is a medical condition in which the blood pressure is chronically elevated. In current usage, the word "hypertension" without a qualifier normally refers to arterial hypertension. The Mayo Clinic specifies blood pressure is "normal if it's below 120/80".

Roux-en-Y Gastric Bypass A type of gastric bypass procedure which combines restrictive and malabsorption techniques - meaning, it reduces the amount of food a patient can comfortably eat (restriction), and also reduces the amount of calories that can be digested in the small intestine (malabsorption). This combination of bariatric methods leads to greater weight loss and the roux-en-y procedure is seen as one of the best ways to treat clinically severe obesity. See WLS Videos for animated surgery technique.

Laparoscopy Laparoscopic surgery, also called minimally invasive surgery is a modern surgical technique in which operations in the abdomen are performed through small incisions as compared to larger incisions needed in open surgical procedures. Laparoscopic surgery belongs to the broader field of endoscopy. The key element in laparoscopic surgery is the use of a laparoscope: a telescopic rod lens system, that is usually connected to a video camera. Also attached is a fiber optic cable system connected to a 'cold' light source (halogen or xenon), to illuminate the operative field, inserted through a 5 mm or 10 mm Trocar to view the operative field. The abdomen is usually insufflated with carbon dioxide gas to create a working and viewing space. The abdomen is essentially blown up like a balloon (insufflated), elevating the abdominal wall above the internal organs like a dome. The gas used is CO2, which is common to the human body and can be absorbed by tissue and removed by the respiratory system.

Obesity Obesity results from the excessive accumulation of fat that exceeds the body's skeletal and physical standards. Obesity has been defined as a weight more than 20% above what is considered normal according to standard age, height, and weight tables, or by a complex formula known as the body mass index. According to the National Institutes of Health (NIH), an increase in 20 percent or more above your ideal body weight is the point at which excess weight becomes a health risk. CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

Registered Dietitian A dietitian is an expert in food and nutrition; A person who has studied diet and nutrition at a college program approved by the American Dietetic Association, completed 900 hours of supervised practical experience accredited by the Commission on the Accreditation for Dietetics Education, and passed an exam to become an R.D. Dietitians help promote good health through proper eating. They also supervise the preparation and service of food, develop modified diets, participate in research, and educate individuals and groups on good nutritional habits. The term "nutritionist" is also widely used; however, the term nutritionist is not regulated as dietitian is. People may call themselves nutritionists without the educational and professional requirements of registered dietitians.