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Flipstash

Gastric Sleeve Patients
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    Flipstash reacted to Pictou in BCBS How to find your requirements   
    You need a copy of your EVIDENCE OF COVERAGE (EOC). Every health insurance company has one that is unique to your group or individual policy. Call customer service and request a copy ASAP. Some will mail a copy, others will send a PDF. Most medicare related policies are required to send a hard copy.
    Then you have to sit down and read the section on bariatric surgery, the section on appeals policy, and the exclusions. You should have 5 appeals, the last two of which will should decided by an independent review committee usually a state official.
    If you work for a huge company or state or county government it is possible that the company or government officials are setting the policy. That's because these entities are usually self-insured. This means they pay their own claims and just pay the insurance company to administer the claim. That also means if your insurance is State of XX insurance by Aetna/Cigna/UH/BCBS your requirements can be different from someone who has a personal or small group policy with the same insurance company.
    I can't answer questions about specific policies. My experience is proof reading and printing copies of policies.

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