Financial and Insurance Information
Obtaining authorization from your insurance company for obesity weight loss surgery can be a challenging process. However all credible institutes will assist you in this process but your cooperation in providing the following documentation will improve your chances of obtaining approval:
- The name of a contact person at your insurance company along with the address to send predetermination or medical review requests.
- As much documentation as you can provide regarding your attempts at dieting and, in particular. any medically supervised diet plans, plus your current weight and height to calculate BMI.
- Documentation of any associated medical problems such as hypertension, diabetes, sleep apnea, or orthopedic problems. Letters from specialists or personal physicians in support of the surgery are particularly beneficial.
Depending on your insurance company, it may be necessary to first get examined in the office before your insurance company will consider a request for any type of bariatric surgery.
Obtaining approval can take up to 4 weeks to complete. Many companies deny an initial request despite our policy of utilizing NIH national criteria in patient selection. In the event you receive a denial, you need to go through the proper channels and appeal. The appeal must come from the policyholder and many companies will back down and approve coverage when faced with a determined patient. We can recommend legal assistance if you receive an unreasonable denial.
For legal assistant in these matters, we suggest contacting Walter Linstrom, Jr at http://www.obesitylaw.com