Michigan Sample Letter to Doctor Requesting Narrative Medical Report
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FAQ
I am writing on behalf of my patient, [Patient Name], to document the medical necessity to treat their [Diagnosis] with [Product Name]. This letter serves to document my patient's medical history and diagnosis and to summarize my treatment rationale. Please refer to the [List any Enclosures] enclosed with this letter.
Several closings can be used in this case: Yours faithfully. Yours sincerely. Yours respectfully. Respectfully.
I was treated in your office [at your facility] between [fill in dates]. I request copies of the following [or all] health records related to my treatment. [Identify records requested (e.g., medical-history form you filled out; physician and nurses' notes; test results; consultations with specialists; referrals).]
Dear: [Contact Name/Medical Director], I am writing on behalf of my patient, [Patient First and Last Name] to document the medical necessity for treatment with [DRUG NAME]. This letter provides information about the patient's medical history, diagnosis and a summary of the treatment plan.
Dear: [Contact Name/Medical Director], I am writing on behalf of my patient, [Patient First and Last Name] to document the medical necessity for treatment with [DRUG NAME]. This letter provides information about the patient's medical history, diagnosis and a summary of the treatment plan.
If you are asked to respond to a medical doctor, address the letter and envelope to Edward Smith M.D., but the salutation should read, "Dear Dr. Smith". Always make sure you have spelled the recipient's name properly.
The narrative request will include a summary of your pertinent medical history collected from your medical records. This summary will set forth the foundation or basis for which your physician had the evidence and information upon which to make a medical opinion.
A typical patient narrative report or warning should be written in a specific way: The exact nature, the intensity of the medical issue and the final outcome of the event. The medical course that led to the event. Drug administration regularity. Counter assessment. Post mortem study (if relevant)
