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Can You Please Read This So I Know I'm Getting "it" Right??



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Does my ins Empire BCBS pretty much say as long as the physician agrees its a go? I have all my tests done my bmi is 42.2, I have letter of medical necessity , phy eval, nusring nutritiousness, etc. The only thing I DONT have is weight records. I never been to a pcp. Is Empire BCBS not asking for this? could this be correct? Could it be that easy? Please read and give me your feedback.

Thanks everyone!!

I'm so annoying I know but so stressing. My paper will be submitted on the 10th after my final nursing program.

forgot the link rolleyes5.gif

http://www.empireblu..._pw_a053317.htm

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This part "The individual must have actively participated in non-surgical methods of weight reduction; these efforts must be fully appraised by the physician requesting authorization for surgery;"

does this mean I don't have to show emprie BCBS my weight loss methods but my physician only? If that is the case I should have no issues since I don't have much but my physician knows this and is fine with it? anyone? anyone??

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your medical team will probably request a history of what programs you've done and how much weight you lost on each. To find out the full requirement list, you should find the page in the benefits book or even call the insurance and ask what specifically must be submitted for approval. My insurance is pretty lenient and only requires document of failed weight loss attempts. I called my bariatric case manager with my insurance and found this is only a simple list of all of the weight loss methods I have tried. My case manager said it did not have to be in depth and only needed to list program names and years.

You can also ask the insurance coordinator at your surgeons office- they should know the requirements.

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