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You have completed your analysis on gastric bypass surgery, and determined whether your insurance carrier will pay for the procedure. You've the CPT/ICD-9 codes memorized, and youre on a basis with the member companies rep at the insurance company. You have prepared the paperwork required by your company, and the big day is finally here: Its time to publish all this information with a request pre-approval of your gastric bypass procedure.

Raise Your Chances of Insurance Success

The checklist below might help you ensure you've received every thing needed seriously to boost your odds of acquiring preauthorizing for weight loss surgery from your insurance carrier:

1. A letter of medical prerequisite from your primary care physician or a medical expert recommending you for fat loss surgery

2. Medical practioners records of office visits saving your history of obesity (this would include documentation supporting The National Institute of Health recommendations of critical and morbid obesity)

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

4. Reveal listing of any doctor-prescribed drugs for weight reduction

5. Supporting documents regarding any medically-supervised weight loss programs

6. Examination records and settlement if underneath the care of a mental health specialist or if taking psychotherapeutic medication, such as for instance anti-depressants

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

Submitting Your Demand

After verifying that you have gathered all necessary documents, any office of one's gastric bypass doctor or your primary care medical practitioner will likely help you in submitting an obtain preauthorization. It's also possible to publish the information yourself, however your request will probably be given more weight if from the doctor.

With your required documents, the letter to your insurance provider from your own doctor may contain relevant information to help in the pre-approval process. This correspondence must demonstrably establish the day, your name, and the reason for the letter (e.g., request for preauthorization). Your date of birth, insurance number, and class number should come straight away after this information, after which the body of the page should follow.

Making Your Case

In the torso of the letter, your physician 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 must also contain your weight and height, and observe that your body mass index (BMI) is excessive for the conditions of obesity. Furthermore, your physician should state plainly that when the weight problem remains, you'd have problems with serious health problems, resulting in a shorter life time. The following are other subjects that should be addressed in your obtain preauthorization:

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The period of time you've been in your health practitioners care exclusively to manage your obesity.

Details of your active participation in proposed diet or treatment remedies. Are the amount of weight lost in following these suggestions and show that you've endured ongoing weight gain after trying these plans.

The present set of health conditions immediately resulting from weight issues, and guarantee why these issues could increase greatly upon losing the excess weight following gastric bypass surgery.

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

A description of the surgery, including details of the advantages you seek to gain from gastric bypass surgery.

Ahead of sending the request, be certain to make copies on your own and a medical doctor or surgeon, and fix all supporting documentation. You may also wish to deliver your letter via registered or certified mail, so you can indicate the time whenever your request was filed and have proof that it was obtained.