Unformatted text preview: provider, has recommended that I have the procedure done outside the network by Dr. Rana del Pastillo at Cleveland Clinic. I have enclosed a letter from Dr. Jennifer Snyder explaining why she recommends a Patellafemoral Arthroplasty (27442). I have also enclosed a letter from Dr. Kunta Semiodome explaining the procedure in detail, his qualifications and experience, and several articles that discuss the procedure. Based on this information, I am asking that you reconsider your previous decision and allow me to go out of network to Dr. Rana del Pastillo for a Patellafemoral Arthroplasty (27442). The procedure is scheduled to begin on December 13, 2011. Should you require additional information, please do not hesitate to contact me at 216-555-1234. I look forward to hearing from you in the near future. Sincerely, Anita Missengal...
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- Spring '11
- Patellafemoral Arthroplasty, Anita Missengal, Dr. Kunta Semiodome, Dr. Jennifer Snyder