Gastric Bypass Surgery Requesting Insurance Pre Approval
You have done your analysis on stomachic bypass surgery, and determined whether or not your insurance carrier can pay for the procedure. you've got the CPT/ICD-9 codes memorized, and you’re on a first-name basis with the member services rep at the insurer. you've got ready the documentation needed by your carrier, and also the massive day is finally here: It’s time to submit all this info with asking for pre-approval of your stomachic bypass procedure.
Increase Your probabilities of Insurance Success
The list below will assist you make sure you have obtained everything required to extend your probabilities of securing preauthorizing for weight loss surgery from your insurance carrier:
1. A letter of medical necessity from your medical aid medical practitioner or a doc recommending you for weight loss surgery
2. Doctor’s records of workplace visits documenting your history of avoirdupois (this ought to embrace documentation supporting The National Institute of Health pointers of severe and morbid obesity)
3. A well-documented list of any serious health problems, like cardiovascular disease or polygenic disease, thought-about an immediate results of severe or morbid avoirdupois
4. a close list of any doctor-prescribed medications for weight loss
5. Supporting documents referring to any medically-supervised diet programs
6. analysis records and clearance if below the care of a mental state specialist or if taking psychotherapeutic medication, like anti-depressants
7. Records of any tests requested by your insurer and their results
Submitting Your Request
After substantiating that you just have gathered all needed documents, the workplace of your stomachic bypass medico or your medical aid medical practitioner can possible assist you in submitting asking for preauthorization. you will conjointly submit the data yourself, however your request can possible incline additional weight if coming back from a health professional.
Along with your needed documents, the letter to your insurer from your doctor can contain pertinent info to assist within the pre-approval method. This correspondence ought to clearly determine the date, your name, and also the reason for the letter (e.g., “request for preauthorization”). Your date of birth, insurance variety, and cluster variety ought to come back like a shot once this info, once that the body of the letter ought to follow.
Making Your Case
Within the body of the letter, your doctor ought to once more state your name, together with your age and gender, and also the semipermanent medical drawback that you're requesting coverage of treatment