| Medica |
|---|
| Insurer Policy |
Medica (Choice) |
| Insurer Status | Approved after first letter (11/15/02) |
| Surgery Type |
Laparoscopic RNY |
| Weeks to approval |
1 |
| Policy |
Must be medically necessary |
| Comments |
The policy I have doesn't require prior authorization as long as it is medically necessary. My surgery and hospital stay are 100% covered by my insurance. After care is also covered and just pay the office co-pay when necessary. I didn't have to write a single letter. I filled out a 7 page questionaire to bring with to my first meeting with the bariatric staff at my clinic (Park Nicollet). No other testing was required expect the pre-op check-up. After meeting with the bariatric staff at my clinic and being approved as a candidate the staff verified that I was authorized by my insurance and I scheduled a surgery date before I left the clinic.
|
| Source |
Therese H |
| Access Medical |
|---|
| Insurer Policy |
Access Medical |
| Insurer Status | Approved after first letter (05/14/04) |
| Surgery Type |
Laparoscopic RNY |
| Weeks to approval |
1 |
| Policy |
Must be medically necessary |
| Comments |
My Doctors office took care of everything. They had me do several tests (dietician, physical therapist, phsycologist, nurse's consult), diet history, etc so they could provide a fully documented letter to the insurance company and I was approved one week later. From my understanding, Health Partners said that the clinic really does their homework before even submitting information to the insurance company which gives them the opportunity to look at it once and make a very educated decision. Thanks to my nurse Barb and Health Partners for getting the ball rolling. |
| Source |
, I |
| Insurer Policy |
Access Medical |
| Insurer Status | Approved after first letter (04/18/04) |
| Surgery Type |
Open RNY |
| Pre-Op BMI |
38.8 |
| Policy |
Must be medically necessary |
| Comments |
Found member customer service to be very knowledgeable and helpful. Very quick to approve me, even with no real health risks other than being overweight. |
| Source |
Elle H |
| Advantage |
|---|
| Insurer Policy |
Advantage |
| Insurer Status | Approved after first letter (6/2005) |
| Surgery Type |
Open RNY |
| Weeks to approval |
2 |
| Policy |
Must be medically necessary |
| Comments |
My insurance okayed me for surgery within two weeks of getting the request from my doctor. The letter says I am able to have the surgery within 1 year of date of okay. My date for surgery is 9/8/2005. |
| Source |
Karen F |
| Aenta |
|---|
| Insurer Policy |
Aenta (18007468429) |
| Insurer Status | Approved after first letter |
| Surgery Type |
Open RNY - proximal |
| MD-supervised programs |
1 0 |
| Comorbidities |
Shortness of breath |
| Source |
Peggy C |
| Aetna |
|---|
| Insurer Policy |
Aetna (PPo Pro Net) |
| Insurer Status | Approved after first letter (12/27/01) |
| Surgery Type |
Laparoscopic RNY |
| Weeks to approval |
5 |
| Pre-Op BMI |
69.5 |
| MD-supervised programs |
1 0 |
| Comorbidities |
Anemia, Hypertension, Asthmatic, Arthritis, Back Pain, Allergies, Sleep Apnea, Major Depression |
| Policy |
Must be medically necessary |
| Comments |
Do you sense that they respond to persistence? Absolutely
What, if anything, would you recommend to others with this company or agency? Keep on them and be proactive.
|
| Source |
Kathleen D |
| Insurer Policy |
Aetna (pos) |
| Insurer Status | Approved after first letter (06/19/00) |
| Surgery Type |
Open RNY |
| Weeks to approval |
1 |
| Pre-Op BMI |
43.6 |
| MD-supervised programs |
1 (52 weeks) |
| Comorbidities |
Arthritis, Joint pain, shortness of breath |
| Policy |
Must be medically necessary |
| Comments |
My letter was sent to the insurance company on
7/19/00. I did get approved but only 80% of
the surgery would be covered if I wanted to go
out of the network. I spoke to my pcp and he
suggested that I see Dr. Tom Jones. A surgeon
in my network that is supposed to be one of the
best around. I have a meeting with him on 8/10/00.
My insurance will cover 100% if I choose to go
with him.
8/31/00 I have chosen to have Dr. Tom Jones do the
surgery. He sent the letter to my insurance company
and I was approved within 3 days. How do you like that
for service! The funny thing is is that my dentist
sent in an approval to pull out a wisdom tooth and I am still
waiting to be approved after 4 weeks. I guess the dentist will
now have to wait. |
| Source |
Kimberley B |
| Insurer Policy |
Aetna (POS) |
| Insurer Status | Approved after first letter (06/28/00) |
| Surgery Type |
Open RNY |
| Weeks to approval |
3 |
| Comorbidities |
Hypertension with some mildly decreased kidney function |
| Policy |
Must be medically necessary |
| Comments |
I didn't have any headaches dealing with Aetna. Really good documentation of your health history & weight loss attempts are essential. |
| Source |
Lori L |
| Insurer Policy |
Aetna (PPO) |
| Insurer Status | Approved after 2nd appeal letter (12/01/00) |
| Surgery Type |
Open RNY |
| Weeks to approval |
6 |
| Pre-Op BMI |
52.5 |
| Comorbidities |
arthritis, asthma, back injury |
| Policy |
Must be medically necessary |
| Comments |
They were easy to deal with, relatively speaking. I sensed no stalling. I did not have to persist very much at all.I think that patients wishing this surgery would be wise to get a good physician's appraisal letter and they will deem it medically necessary.
Update- as of 7-16 I started receiving notices that the ins. co. was not paying my bills and after calling them, they told me that my request for payment had **NEVER** been approved. I was in shock, angry and called a lawyer. They said I must put in an appeal to the inc. co. I did that and discovered that the surgeon I had trusted had misinterpreted the letter the ins. co. sent them. That letter said that the surgery was covered under my policy, but did not guarantee pmt. of benefits until that surgery actually took place, at which time they would determine pmt. It all turned out that the surgeon took it(the letter) to mean what they & I wanted it to be, that it had been approved. I had never been told anything which set "precertification" apart from approval. I was told after the fact that precertification and approval have nothing to do with each other. I now have a medical bill of approx. $32,000 to try to figure out how to pay. I am seeking an ERISA plaintiff law attorney to assist with this. I just got the info last nite from my therapist.
Anyone reading this, PLEASE be very careful about what you are told. Document everything!
Flash, flash!! It took 4 mo. and intervention of my employer's director of employee benefits but it was discovered that when the new policy our company set up with Aetna went into effect, the status of **medically necessary** gastric bypass surgery was never taken into consideration. So, thru all the worry and tears, I was finally able to smile when I rec'd word from my employer that they indeed would fund the payment of all (**100%** as I have high PPO)the bills for the surgery. I am more grateful than I could ever say! The policy is self-funded by my employer (meaning they paid the bills) and I truly have my employer to thank. |
| Source |
Terry Lynn D |
| Insurer Policy |
Aetna (POS) |
| Insurer Status | Approved after first letter (08/23/00) |
| Surgery Type |
Laparoscopic RNY - proximal |
| Weeks to approval |
2 |
| Comorbidities |
Elevated triglycerides, high cholesterol |
| Policy |
Must be medically necessary |
| Comments |
It actually only took 13 days from the time they received my request to approval. My surgery is scheduled for end of Sept. 2000 |
| Source |
T A |
| Insurer Policy |
Aetna (EPO) |
| Insurer Status | Approved after first letter (2/21/01) |
| Surgery Type |
Laparoscopic RNY - proximal |
| Weeks to approval |
3 |
| Pre-Op BMI |
55.1 |
| MD-supervised programs |
1 (16 weeks) |
| Comorbidities |
back pain, out of breath easy, heartburn, could not exercise |
| Policy |
Must be medically necessary |
| Comments |
2/1/2001
After faxing the info 3 times they finally received it. That is only after putting it to someone's attn, not the generic "Clinical Review Unit". Was told it was received today and that it will take about 2-3 weeks to have an answer as they are "swamped".
2/16/2001
Still no answer..I have been calling every day to see if there is an answer yet. Not one yet. Cannot actually talk to anyone, just have to keep messages and no one is returning my call.
2/20/01
After calling every single day was finally approved. Took over a week for them to receive the info. It was faxed but there was mix up with the fax # on their part. Took another 2 weeks to finally get the pre-d to the person to get it to be reviewed. Once that person had it took from Friday till Monday and it was approved.
I would highly recommend to others to be persistant, call everyday to make sure they do not forget about you.
|
| Source |
Kathleen R |
| Insurer Policy |
Aetna (Pcp) |
| Insurer Status | Approved after first letter (02/01/01) |
| Surgery Type |
Open RNY |
| Weeks to approval |
5 |
| Comorbidities |
hypertension, depression |
| Policy |
Don't know |
| Comments |
They were quite easy to deal with. They only requested more information. The doctor immediately sent it out and I was approved less than a week after they received the information. |
| Source |
Jeff C |
| Insurer Policy |
Aetna (EPO) |
| Insurer Status | Approved after first letter (02/28/01) |
| Surgery Type |
Open VBG |
| Weeks to approval |
8 |
| Pre-Op BMI |
64.6 |
| Policy |
Must be medically necessary |
| Comments |
Dr. Rupps office is sending letter for approval to Aetna this week. Will see what happens. The nurse advised me to give it about 3 weeks. I have gotten different responses from Aetnaover the phone and on the net as to what it takes to get approval.
5/10/01- Well, It took forever seems like but I was finnaly approved by my insurance company for surgery. Talk about hoops though. You have to jump through many, many of them. I have spent more time on the phone between Aetna, and different doctors then you would believe! I have spoke to 4 different people the last 2 weeks with Aetna and got 4 different responses- Some say I need certification for the pschy eval, some dont, some say I am covered, some say I am not- They gave me 2 providers in my area for the eval. One is no longer in business, and the other did not do pschy evals!
Much time has been spent on hold with Aetna- I guess though even with all the headaches I should be happy I was approved- I did get the pscych eval scheduled- finally! After being transferred and told to call about 8 different numbers.
Joyce, Dr Rupps nurse has been great at returning my calls and keeping me informed. My pschy eval is May 22, 01.
5/22/01- psche eval 2nd session is done- found out aetna will not cover the testing though |
| Source |
Dave C |
| Insurer Policy |
Aetna |
| Insurer Status | First letter sent - still waiting (05/15/01) |
| Surgery Type |
Open RNY |
| Pre-Op BMI |
51.0 |
| Source |
Susan O |
| Insurer Policy |
Aetna (EPO) |
| Insurer Status | Approved after first letter (11/07/2001) |
| Surgery Type |
Laparoscopic RNY |
| Weeks to approval |
1 |
| Pre-Op BMI |
46.6 |
| MD-supervised programs |
1 (5 weeks) |
| Comorbidities |
Asthma, Diabetes, High Cholesterol & High Blood Pressure |
| Policy |
Must be medically necessary |
| Comments |
WLS Criteria: 1)Obesity w/ 2 or more co-morbidities 2)Morbid Obesity w/ a BMI over 40. 3)Documented history of atleast 2 medically supervised weight loss attempts.
110701 I have to be honest & say it was a very "irritating" experience, but it didn't take long once the info was sent to the correct person, one week was all it took. Since I'm also an Aetna employee it was more convenient because I was able to communicate with the precert department via e-mail. I'd say they definitely respond to persistence. I didn't meet there "criteria", however I asked them to send it to the medical director for review today & within 4-6 hours I was advised it was approved. Now that's some good service!
My advice is to call & call often. Make sure you have all the correct info for the point of contact person who will receive your predetermination request with your insurance company. I went a week without knowing the info had changed. Since I started looking into this 5 months ago there info changed 3 times, so stay on them! |
| Source |
Sarah A |
| Insurer Policy |
Aetna (EPO) |
| Insurer Status | Approved after appeal letter (3/29/02) |
| Surgery Type |
Laparoscopic RNY |
| Pre-Op BMI |
43.5 |
| MD-supervised programs |
2 (82 weeks) |
| Policy |
Must be medically necessary |
| Comments |
3/21/02
Its been easy so far... I called to make sure that there was no exclsion policy and there wasn't. I had to meet the standard parameters, which I do, so now Im waiting for ins. to get the letter from my surgeons office. They are refaxing to ins. today.
*******************
3/25/02
I called today and insurance has my paperwork. They've sent a form for my surgeon to fill out. Once he does, Ive been told that they review the information to make sure that I meet the requirements, then will send their approval within 48 hours.
***************
3/29/02
Im so frustrated... when I called today to check on the status of my request, they said that I was denied! WHAT?! It turns out that they need documented medical records that I had medically monitored weight-loss attempts, which I did have with Phen-Fen and Meredia, however if you're like me the doctors would just tell me to go away and eat a well balanced diet and exercise. When I came in to the doctor because my calves looked like I was trying to be a body builder and wasnt losing weight from walking, they told me to see a nutritionist. Thanks! Anyway, besides getting them more info, they also say that my Surgeon isnt covered, so that office is trying to get him on my ins. plan... what a mess! The surgery office still thinks that May 16th is do-able! Say your prayers for me!
***************
10/7/02
Wow! I just noticed how longs its been since I wrote in here. Actually if you read my profile, you will see all that I've been dealing with regarding insurance. Bottom line is that in the next day or two I should have my answer to my appeal - surgery is scheduled 10/18/02 (in 11 days!) - wish me luck!
~~~~~~~~~~~~~~~~~~~~~
10/8/02
Im approved! YAY! |
| Source |
Julie L |
| Insurer Policy |
Aetna (PPO) |
| Insurer Status | Approved after legal action taken (10/04/02) |
| Source |
Darlene P |
| Insurer Policy |
Aetna (Distinctions) |
| Insurer Status | Approved after first letter (08/02/03) |
| Surgery Type |
Laparoscopic RNY |
| Pre-Op BMI |
51.5 |
| Source |
Laura M |
| Insurer Policy |
Aetna (PPO) |
| Insurer Status | Approved after 2nd appeal letter (02/01/04) |
| Weeks to approval |
32 |
| Comorbidities |
Sleep apnea, GERD, arthritis, depression, hypertension, high cholesterol, familys history of heart d |
| Policy |
Must be medically necessary |
| Comments |
I think Aetna denies on the first request just to see if you are serious. Their policy calls it an exclusion, but will approve if you meet all thier criteria, which is very extensive.
I don't think they stall, but you must have met every single one of their criteria or forget it. They are real sticklers. I did not get much help from the surgeon's office. I did all the research on requirements myself. I called and tracked down all my medical records from 2 years back along with all the other things they required. It took a long time and a lot of persistence. Be sure you know what they require, get names and dates of everyone you talk to at Aetna and what they said. Document, document, document! |
| Source |
Patricia F |
| Insurer Policy |
Aetna |
| Insurer Status | Approved after first letter (03/12/04) |
| Surgery Type |
Laparoscopic RNY |
| Source |
Julie M |
| Insurer Policy |
Aetna |
| Insurer Status | Approved after first letter (10/04/04) |
| Surgery Type |
Open RNY |
| Weeks to approval |
8 |
| Pre-Op BMI |
55.2 |
| MD-supervised programs |
2 (24 weeks) |
| Comorbidities |
Sleep apnea, hypertension, arthritis |
| Policy |
Must be medically necessary |
| Comments |
Although the wait was long enough to disturb my sleep patterns, it was a relatively simple process. The folks at SMDC submitted the paperwork on August 12th, which Aetna had received and processed by 8/20. Then, the challenges began - they lost the paperwork in their system twice. I spoke with an Aetna representative on 9/20, who instructed me to start calling on a daily basis if I hadn't heard anything by 9/30. I received the approval in the mail on 10/01. I have to say, everyone at SMDC was solidly behind the process, as were the customer service representatives at Aetna. |
| Source |
Lynne B |
| Insurer Policy |
Aetna |
| Insurer Status | Denied after first letter (11/01/04) |
| Source |
Dale P |
| Insurer Policy |
Aetna (PPO) |
| Insurer Status | Approved after first letter (11/05/04) |
| Surgery Type |
Laparoscopic RNY - distal |
| Source |
Todd D |
| Insurer Policy |
aetna |
| Insurer Status | Approved after first letter (07/15/05) |
| Surgery Type |
Laparoscopic RNY |
| Source |
Laura F |
| Insurer Policy |
AETNA (PPO) |
| Insurer Status | Denied after first letter (09/26/05) |
| Source |
Nancy B |
| Insurer Policy |
AETNA |
| Insurer Status | First letter sent - still waiting (07/19/06) |
| Comorbidities |
GERD, Diabetes, Hypertension, Hypercholesterolemia, Shortness of breath, Stress incontinence |
| Source |
Jami B |
| Insurer Policy |
Aetna (PPO) |
| Insurer Status | Approved after first letter |
| Surgery Type |
Laparoscopic Lap Band |
| Weeks to approval |
2 |
| Pre-Op BMI |
43.2 |
| Comorbidities |
Chronic skin conditions, Depression |
| Policy |
Must be medically necessary |
| Comments |
The whole process was quite simple. Unity staff took care of everything and just guided me through the process. |
| Source |
Shannon A |
| Insurer Policy |
Aetna |
| Insurer Status | Approved after appeal letter (4/10/2008) |
| Surgery Type |
Laparoscopic RNY |
| Pre-Op BMI |
53.4 |
| Comorbidities |
Sleep Apnea |
| Policy |
Must be medically necessary |
| Source |
Melissa A |
| Insurer Policy |
Aetna |
| Insurer Status | (03/28/08) |
| Surgery Type |
Laparoscopic RNY |
| Weeks to approval |
1 |
| Comorbidities |
high cholesterol, GERD |
| Policy |
Must be medically necessary |
| Comments |
Much smoother than anticipated. They responded so quickly - 3 business days!! |
| Source |
Erica B |
| Insurer Policy |
Aetna (Hartford Life- FBO Mellody Tre) |
| Insurer Status | Approved after appeal letter |
| Comorbidities |
Arthritis, Hypertension, Depression, Shortness of breath, Stress incontinence |
| Source |
Mellody T |
| Aetna EPO |
|---|
| Insurer Policy |
Aetna EPO (EPO) |
| Insurer Status | Approved after first letter |
| Surgery Type |
Laparoscopic RNY |
| Weeks to approval |
2 |
| Comorbidities |
joint pain, high blood pressure |
| Policy |
Must be medically necessary |
| Comments |
very easy. My Park Nicollet clinic sent in all the paper work and the request and it was approved with in 2 weeks. |
| Source |
Dedra H |
| Allina |
|---|
| Insurer Policy |
Allina |
| Insurer Status | Approved after first letter (02/02/00) |
| Surgery Type |
Open RNY - proximal |
| Weeks to approval |
1 |
| Pre-Op BMI |
41.0 |
| Comorbidities |
Clinically diagnosed Co-morbidities at time of last action. Ex: Sleep apnea, arthritis, hypertension |
| Policy |
Must be medically necessary |
| Comments |
I was very lucky, plain and simple. We submitted and within a week was approved. I know this to be unusual. My wife plans on having the surgery in July and we already kow it will be a much more difficult process for her since we have changed insurers. |
| Source |
Paul M |
| Insurer Policy |
Allina (Allina Employee Care Plan) |
| Insurer Status | Approved after first letter (4/18/2003) |
| Surgery Type |
Open RNY - distal |
| Pre-Op BMI |
43.8 |
| MD-supervised programs |
2 (68 weeks) |
| Comorbidities |
None, other than strong family history of diabetes. |
| Policy |
Must be medically necessary |
| Comments |
Joyce from Dr. Kelly's office is working with them. I didn't have to deal with them at all. She handled everything. |
| Source |
Stephanie E |
| Insurer Policy |
Allina |
| Insurer Status | Approved after first letter (12/14/02) |
| Surgery Type |
Laparoscopic RNY - distal |
| Pre-Op BMI |
38.4 |
| Comorbidities |
diabetic(insulin,oral controlled) athritis, hiatal hernia, hypertension, mitral valve prolaspse |
| Comments |
judy schwartz dealt with the insurance company. she is very knowledgeable in these matters. she is the coordinater of the clinic. |
| Source |
Lucille Y |
| Insurer Policy |
Allina |
| Insurer Status | Approved after first letter (11/20/03) |
| Surgery Type |
Open RNY |
| Policy |
Don't know |
| Comments |
I never had to deal with my insurance company because Dr.F.Johnson's office dealt with them for me!!!I was approved right away, I had to wait one day b/c the girl that deals with the insurance was out of the office..it really was no big deal though. |
| Source |
Annie B |
| Altru |
|---|
| Insurer Policy |
Altru (Blue Cross of North Dakota) |
| Insurer Status | Approved after first letter (10/22/2008) |
| Surgery Type |
Lap Band |
| Weeks to approval |
1 |
| Pre-Op BMI |
50.3 |
| Comorbidities |
Shortness of breath, foot pain, headachs, hypertension, anixtey |
| Policy |
Must be medically necessary |
| Source |
Judy R |
| American Family |
|---|
| Insurer Policy |
American Family |
| Insurer Status | Denied after first letter (12/02/02) |
| Policy |
Written exclusion policy |
| Comments |
I'm just wondering if anyone else has dealt with American Family regarding this issue?? They say they have an exclusion for bariatric surgery, so after almost a year of tests and dr. appts, they now tell us this. |
| Source |
Jackie D |
| ANGELA IMDIEKE |
|---|
| Insurer Policy |
ANGELA IMDIEKE (MINNESOTA CARE BCBS) |
| Insurer Status | Approved after first letter |
| MD-supervised programs |
1 (12 weeks) |
| Comorbidities |
GERD, Hypertension, Depression, Shortness of breath |
| Source |
Angie I |
| Anthem Blue Cross |
|---|
| Insurer Policy |
Anthem Blue Cross |
| Insurer Status | Approved after first letter (12/08/06) |
| Surgery Type |
Laparoscopic RNY |
| Weeks to approval |
3 |
| Pre-Op BMI |
45.2 |
| Comorbidities |
Sleep Apnea, Gerd |
| Policy |
Must be medically necessary |
| Comments |
Insurance comp received 1st requst & had it for about 3 weeks (over Xmas) then said they needed more info from provider. Turned out they wanted to make sure I was keeping the same insurance policy into 2007 & was was my date. Cleared that up & had was approved right away. Now they still don't want to cover dietian appointments. So that will be next to deal with. |
| Source |
Deb P |
| Insurer Policy |
Anthem Blue Cross |
| Insurer Status | Denied after appeal letter (09/06/05) |
| Comments |
I have Blue Cross Anthem of Kentucky and they denied my surgery byh 4 weeks. The doctor's office sent in more information and again it was denied. Now, I am having to put in a second appeal, which is very frustrating. I don't know if it is worth the bother to fight them. |
| Source |
Kathy G |
| Insurer Policy |
Anthem Blue Cross |
| Insurer Status | Approved after first letter |
| Surgery Type |
Laparoscopic Lap Band |
| Source |
Elizabeth T |
| Anthem Blue Cross Blue Shield |
|---|
| Insurer Policy |
Anthem Blue Cross Blue Shield |
| Insurer Status | Approved after first letter (02/27/06) |
| Surgery Type |
Laparoscopic RNY |
| Comorbidities |
Depression, Hypertension, Shortness of breath, Sleep apnea |
| Policy |
Must be medically necessary |
| Source |
Josh S |
| Anthem BlueCross and BlueShield |
|---|
| Insurer Policy |
Anthem BlueCross and BlueShield |
| Insurer Status | Approved after first letter (8/20/08) |
| Weeks to approval |
1 |
| Policy |
Must be medically necessary |
| Source |
Jen A |
| ARAZ thru Employee Group Services |
|---|
| Insurer Policy |
ARAZ thru Employee Group Services (EGS) |
| Insurer Status | (04/24/01) |
| MD-supervised programs |
2 (12 weeks) |
| Source |
Kristen B |
| assure care |
|---|
| Insurer Policy |
assure care |
| Insurer Status | Approved after first letter (11/16/02) |
| MD-supervised programs |
1 (4 weeks) |
| Source |
Amy G |
| B/C/Blue Sheild |
|---|
| Insurer Policy |
B/C/Blue Sheild |
| Insurer Status | Approved after first letter (12/01/06) |
| Surgery Type |
Laparoscopic RNY |
| Weeks to approval |
2 |
| Comorbidities |
Sleep apnea, Arthritis, Chronic skin conditions, Depression, Shortness of breath, Stress incontinenc |
| Policy |
Must be medically necessary |
| Source |
Teresa N |
| bc/bs |
|---|
| Insurer Policy |
bc/bs |
| Insurer Status | Approved after first letter (02/26/05) |
| Surgery Type |
Laparoscopic RNY |
| Pre-Op BMI |
39.3 |
| Comorbidities |
sleep apnea, gerd |
| Policy |
Must be medically necessary |
| Source |
Rachell W |
| BC/BS Blue Plus |
|---|
| Insurer Policy |
BC/BS Blue Plus |
| Insurer Status | Approved after first letter (4/24/06) |
| Surgery Type |
Laparoscopic RNY |
| Comorbidities |
Asthma, Depression, GERD, High Cholesterol, Hypertension, Shortness of breath, Probable Sleep apnea, |
| Policy |
Must be medically necessary |
| Source |
Gayle P |
| BC/BS MN |
|---|
| Insurer Policy |
BC/BS MN |
| Insurer Status | (11/21/2006) |
| Surgery Type |
Laparoscopic Lap Band |
| Weeks to approval |
2 |
| Pre-Op BMI |
42.3 |
| Policy |
Must be medically necessary |
| Source |
Nancy P |
| BC/BS of Georgia |
|---|
| Insurer Policy |
BC/BS of Georgia (PPO) |
| Insurer Status | Approved after first letter (07/11/06) |
| Surgery Type |
Laparoscopic RNY |
| Pre-Op BMI |
53.7 |
| Comorbidities |
Sleep apnea, Hypertension, Depression, Shortness of breath, herniated discs in low back |
| Source |
Rich C |
