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-   -   Letter of Medical Necessity (https://www.adrsupport.org/forums/showthread.php?t=8073)

fiddle 07-18-2006 02:18 PM

Hello everyone, I leave for Germany this Sunday. Surgery with Dr. Zeegers on July 28th. My insurance company wants a Letter of Medical Necessity by the doctor, faxed to them several days before the surgery. Does anyone know if Dr. Zeegers does this? I have emailed him twice but have not heard back yet. Perhaps he is waiting to talk with me personally.

Thank you for any insights you might have!

I am starting to get concerned because I would like to get the letter in. My primary might be able to write it but I don't think she's the best source...shouldn't it come from the surgeon? And I see her for a brief visit in two days -- I don't see how she'll find the time to write it!

Alastair 07-18-2006 02:46 PM

E mail Agnes Ramerez or talk to her and she should fix that for you - - -- not heard of it before - - - but insurance -- - - - - http://adrsupport.org/groupee_common...icon_smile.gif http://adrsupport.org/groupee_common...icon_smile.gif http://adrsupport.org/groupee_common...icon_smile.gif

ramirez@alphaklinik.de

Best
Alastair http://adrsupport.org/groupee_common...icon_smile.gif

hucky 07-18-2006 03:39 PM

Hi Fiddle,

Best wishes for your surgery. You're in good hands.

Hucky

fiddle 07-18-2006 05:19 PM

Thank you Alaister and Hucky.

I tried to contact Agnes, but she is out of the office until July 24th and I will be arriving there that day. I also tried Nicole and Dr. Zeegers.

Hopefully this is something he can do a few days before my surgery.

Alastair 07-19-2006 08:47 AM

E mail Zeegers on both these E mail addys
zeegers@alphaklinik.de

wzeegers@zeta.demon.ni

Dr Zeegers is doing a lot of lecturing just now -- - --someone should be covering for Agnes but I don`t know who at present
Best
Alastair http://adrsupport.org/groupee_common...icon_smile.gif

Alastair 07-19-2006 12:13 PM

Vicky J cannot get on the board but can read postings but cannot post has said by e mail to me

Heike Kreminski if Agnes is away. She seemed to be the lead liason person whilst I was there - every time. kreminski@alphaklinik.de

Vicky was there this year twice -- - - - try everything!!!!!
Best
Alastair http://adrsupport.org/groupee_common...icon_smile.gif

fiddle 07-19-2006 02:03 PM

Thank you Alastair. I heard from Ingrid Mulder today. She said Dr. Zeegers forward my email to him to her. In the email she said that she was sorry he could not comply with the request..."we never deal with insurance companies, only with patients". Of course I am disappointed because if insurance were to approve it I could save close to $40,000 dollars!

So I have an appointment to see my primary tomorrow, and she will probably (hopefully) write up something, but I think it would have been so much more effective coming from the surgeon. I understand that he hasn't actually evaluated me personally yet, but I had hoped maybe I could have the testing next Tuesday, and he could write and fax then, 3 days before surgery.

Oh well. Not much more I can do with this. Sigh.

Mariaa 07-20-2006 07:08 AM

My feeling on this one is if these surgeons are willing to take US patients on, they should at least be able to write a letter of Medical Necessity. All that is needed is a standard form letter taken from a history and treatment plan for patient/surgery intended and why this surgery is deemed appropriate and necessary for the patient.

It's not that big of a deal~ and it could potentially save a patient/client quite a bit of $$$.. I don't care for that reply even tho I know we are desperate to have the best treatment possible. This is big money that could be saved possibly. I hope you will be able to get your primary to write one for you that would be acceptable however, even here in the states, WC was requesting this from a surgeon that I had consulted with and we got nothing/no reply.. so I went back to my PTP (primary treating physician) and we are requesting this from him.. if not him, then there is another surgeon that could be utilized but I would have to switch primary treating physicians..

I understand the surgeon doesn't have time and so forth, but again, it can be a pretty standard form type of thing with the individual's own history and treatment plan written into it... the doc's/surgeon's secretary here ends up doing most of the work.. (can be taken from dictation or however it's done now)~

Don 07-20-2006 10:39 AM

I agree with Mariaa, any doctor should be willing to help their patients. My surgeon and my rheumatologist both have written them for me. It takes ten seconds to dictate a letter and their assistants do the writing. It's preety unfortunate that the surgeon won't but I hope your primary care doctor will. Good luck fiddle!

Alastair 07-20-2006 10:46 AM

I Don't understand this at all, I would have thought that Dr Zeegers would have had x-rays, and he could of justified a least the surgery that he was going to do, not only with the x-rays but probably with the questionnaire as well. I know at the moment he is away from the Alphaklinik lecturing -- -- -- or he was last time I spoke to Agnes.

Insurance companies seem to cause a heck of a lot of problems in the USA
Cheers,
Alastair http://adrsupport.org/groupee_common...icon_smile.gif


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