Provided by:
Amjo Corp
PO Box 8304,
West Chester,
Ohio, 45069
Tel: 513-942-2770
Fax: 513-942-2771
The letter below should be written by your doctor on his or her stationery
Please PRINT a copy of this letter as a sample for your Doctor.
June 1, 2004
To Whom it May Concern:
RE: Jane Smith (DOB)
This patient has been under my care since March 1, 2004. Patient suffers from severe psoriasis, which would also be classified as generalized intractable psoriasis over much of patient’s abdomen and legs. Patient has been treated with numerous medications including topical moisturizers, topical steroids, and with ultraviolet lights. Patient has shown the most significant improvement utilizing ultraviolet (UV-B) phototherapy. Patient’s psoriasis has improved by over 50% during the previous 2 months of treatment at a phototherapy clinic. This treatment must be continued for the next 3 to 4 months with a frequency of 3 times per week.
A home-based ultraviolet light panel/cabinet would be equally effective and offer positive economic benefits to both the patient and their insurance provider due to the fact that the patient requires a minimum of 40 additional treatments at a phototherapy facility with each visit costing $65 or a minimum course of treatment cost of $2,700. A home-based unit would be significantly less expensive than the in-clinic costs. Since Psoriasis is usually a life-long condition which requires long-term maintenance to prevent future flare-ups, the patient will most likely require light treatments for the rest of the patient’s life to control their psoriatic condition, which the patient would be able to do from their home. The manufacturer’s devices have a essentially identical effectiveness profile as the ultraviolet lights used in the psoriasis treatment center.
Therefore, I am recommending a National Biological 6-Foot Panosol II, with UVB Narrowband lamps due to the device’s ease of use, effectiveness and relative safety due to its maximum exposure time allowed, coupled with its controlled prescription timer. The timer requires the patient to be periodically seen in our medical offices after a prescribed number of treatment sessions. This will allow our office to monitor the patient’s progress. I feel the patient is capable of operating the ultraviolet light box and staying within prescribed exposure times.
Sincerely,
John Q. Doctor, M.D.
BOLD TEXT SHOULD BE EDITED/CHANGED BY THE WRITER
