You have completed your research on gastric bypass surgery, and decided whether your insurance carrier will probably pay for the procedure. You’ve the CPT/ICD-9 limitations memorized, and youre on a basis with the member services repetition at the insurance company. You’ve prepared the documentation required by your company, and the wedding day is finally here: Its time to submit all this information with a request for pre-approval of your gastric bypass procedure.

Increase Your Chances of Insurance Achievement

The list below might help you ensure you’ve received everything needed seriously to boost your likelihood of obtaining preauthorizing for weight reduction surgery from your insurance carrier:

1. A letter of medical prerequisite from your primary care physician or perhaps a medical specialist recommending you for weight loss surgery

2. Medical practioners records of office visits showing your history of obesity documentation should be included by this supporting The National Institute of Health instructions of critical and morbid obesity)

3. A well-documented listing of any significant medical issues, such as hypertension or diabetes, considered due to of extreme or morbid obesity

4. A detailed listing of any doctor-prescribed medications for weight reduction weight loss maryland

5. Promoting documents regarding any medically-supervised diet plans

6. Analysis records and approval if underneath the care of a mental health specialist or if using psychotherapeutic treatment, such as for instance anti-depressants

7. Documents of any tests required by their effects and your insurance company

Submitting Your Request

After verifying that you’ve obtained all required documents, the office of one’s gastric bypass physician or your primary care medical practitioner will likely help you in submitting an obtain preauthorization. You may even send the info yourself, however your request will likely be given more weight if from a medical practitioner.

Along with your necessary files, pertinent information will be contained by the letter to your insurance company from your doctor to greatly help in the pre-approval process. This communication must clearly identify the date, your name, and the reason why for the letter (e.g., request for preauthorization). Your date of delivery, insurance number, and group number should come instantly after this information, after that your body of the page should follow.

Making Your Case

Within the body of the letter, your medical practitioner must again state your name, along with your age and sex, and the long-term medical problem that you are seeking coverage of treatmentin this case, severe or morbid obesity.

The body of the page should also include your weight and height, and note that your body mass index (BMI) is excessive for the criteria of obesity. Furthermore, your doctor must state obviously when the weight problem continues, you’d suffer with serious health threats, causing a shorter life span. The following are other issues that needs to be addressed in your request for preauthorization:

The period of time you have been in your health practitioners care specifically to control your obesity.

Details of your active involvement in proposed diet or medication treatments. Include the quantity of weight lost in following these suggestions and show that you have endured continued weight gain after trying these plans.

The current listing of health conditions immediately caused by weight issues, and guarantee why these issues would improve greatly upon reducing the excess weight following gastric bypass surgery.

The procedure expected to occur, the surgeon expect to execute the procedure, the telephone and address number of the surgeon or bariatric treatment center, and the expected amount of hospital stay.

A description of the surgery, including information on the huge benefits you seek to gain from gastric bypass surgery.

Ahead of sending the request, be certain to create copies on your own and your physician or surgeon, and add all supporting documentation. You might also wish to deliver your letter via registered or certified mail, so you can indicate the date when your request was filed and have evidence that it was received.