troublemaker

Ok here we go again! Called Rengecy BCBS again and talked to somebody that knew what was going on. What they said is if the facility Is a " Center of Excellence" facility and deam it medical nessarsary to have the lap band done over the full gastric bypass, they can request the lap band be done instead! So I called the surgeon's office and told them that, and the said they are a "COE" facility but they have never heard of filing an appeal in the case of the lap band being excluded from the insurance policy. So maybe we have a chance!

They also told me that it was due to the elections that my employer choose while setting up our new insurance. So my employer opted out of the lap band, but opted in for full bypass.

Well called my insurance company and they told me that the lap band is not covered but full bypass is. Then I asked them about what their web site said and they couldn't answer me!

I know what the procedure is, but I can't belive they consider it a weight loss program! Has anybody else ran into this?

Wel, my doctor ran a pre auth. to my insurance, and I was aproved for a "full bypass" but not the "lap band" because it is considered a weight loss program. Now, I went to my insurance web site and logged in and put in what procedure is was considering "lap band" and what their web site said was... I was covered 100% for the "lap band". So I went back a page and put in "full bypass" I was also 100% covered. With that said, who is right?

Well my employer is considering the lap band a "program" and programs are not covered. What is covered is a full bypass.

Is the medical code for the lap band 43770?

Looking at my employee hand book, weight loss programs are not covered.....Duh! With that being said is the Lap Band procedure considered a "Weight Loss Program"?

Would yall consider the Lap Band prcedure a "weight loss program"?

I just recieved a letter from my doctor stating that Regence BCBS doesn't cover the lapband but does cover Laparoscopic bypass only. Has anybody else ran into this?