Letter of Medical Necessity - anyone seen this?

[Guest guest]

I just got my copy of the letter of medical necessity that the Dr.

sent my insurance. All it says is: " was evaluated and

diagnosed with positional plagiocephaly. Helmet therapy was

prescribed. This treatment is medically necessary to correct the

shape of his head "

That's it. All the sample ones I've seen have been much more

detailed. Is this gonna cut it with the insurance or should I call

and request more?

TIA,

Kristi

(4) and (1yr - banded 9/14/02)

OH

[Guest guest]

Kristi,

My letter was very similar. It said "the DOC band is needed for severe plagiocephaly with torticollis. Torticollis occurred in Sam and Sara resulting in moderate/severe plagiocephaly." It was brief and redundant, but Cigna (believe it or not) accepted it as a letter of medical necessity. If your doctor will write a better one based on some of the samples, then go for it. If not, then at least you have something. This was the best I could do, and it took me 4 months to get this. Good luck.

Gail, Sam and Sara's mom, DOC grads

Letter of Medical Necessity - anyone seen this?

I just got my copy of the letter of medical necessity that the Dr. sent my insurance. All it says is: " was evaluated and diagnosed with positional plagiocephaly. Helmet therapy was prescribed. This treatment is medically necessary to correct the shape of his head"That's it. All the sample ones I've seen have been much more detailed. Is this gonna cut it with the insurance or should I call and request more?TIA,Kristi (4) and (1yr - banded 9/14/02)OHFor more plagio info

[Guest guest]

i am appealing my insurance now and the first letter mydoctor sent was more detailed. i would ask for something more detailed. I hope everything goes thru smoothly with the insurance.

Letter of Medical Necessity - anyone seen this?

I just got my copy of the letter of medical necessity that the Dr. sent my insurance. All it says is: " was evaluated and diagnosed with positional plagiocephaly. Helmet therapy was prescribed. This treatment is medically necessary to correct the shape of his head"That's it. All the sample ones I've seen have been much more detailed. Is this gonna cut it with the insurance or should I call and request more?TIA,Kristi (4) and (1yr - banded 9/14/02)OHFor more plagio info

[Guest guest]

Beck,

I couldn't agree more with the " cheesy of him " comment. I was

shocked. There was also a typo!! You would think with it having

taken several weeks to get this from them that it would have been

more detailed. I had them send a copy straight to the insurance, so

they have it. I was going to call the ins and see if it will be

enough. Thanks for the advice!

Kristi

(4) and (1yr - Docbanded 9/14/02)

OH

> Kristi start with that so you can get it in and then take a sample

of another

> letter to your DR and request that he revise or atleast state his

reasons in

> details. Just tell him ins. requires a more detailed understanding.

That is

> cheesy of him I could have written that letter of medical necessity!

> beck

[Guest guest]

Kristi,

Well, it does seem a bit sparse, but it says what it needs to say - that the

treatment is medically necessary. I think these drs believe that because they

say it is medically necessary that should be enough - and that is true! However,

your insurance company might want some elaboration. I guess you could send it in

and see if the insurance co comes back saying they need more info.

Marci (Mom to )

Oklahoma