INSURANCE INFORMATION FOR LAPBAND® SURGERY
Obtaining insurance authorization for weight loss surgery can be frustrating and time consuming. Despite the fact that weight loss surgery is endorsed by the National Institutes of Health as the only effective treatment for morbid obesity, some insurance policies do not cover any weight loss surgery. Obtaining insurance authorization usually involves the following steps:
- Determine if weight loss surgery is a covered benefit in your policy.
- Determine the criteria for coverage (such as weight, BMI, previous weight loss attempts, etc.).
- Determine which weight loss procedure(s) your policy covers.
- Obtain documentation (such as chart notes from previous doctor visits) that you may need to meet all the criteria for coverage by your insurance policy. We will then prepare a comprehensive letter of medical necessity outlining your situation and send it to your insurance company requesting approval for your weight loss surgery.
You need to take an active role in gathering this information. We have outlined the process in detail within this handout to make it as simple and efficient as possible. We recommend that you document every step of the way. It is becoming increasingly difficult to obtain coverage for weight loss surgery with some insurance companies. Many insurance companies' criteria require participation in a physician monitored weight loss program to qualify. Your chances of being approved for weight loss surgery will be greatly improved if you gather the information they require. We will submit a complete package of information for you covering all the insurance policy requirements together with our letter of medical necessity.
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