Medicare?

[citygirl1962 50]

Did anyone have Medicare for their bypass? My file should go to the insurance coordinator this week. Since there is no pre-certification with Medicare, I am wondering how this part of the process will go?

[Bigguy9347 16]

My insurance was medicare. What are you meaning no pre certification. Medicare Requires 3 month's documentation with progress notes. And like everything else they cover all but 20% if you have met you ded. in arkansas it amounts to around $1400.00. I litteraly just went over all of this with billing 2 months ago because I had other insurance that was canceled out of the blue. Good thing was once I had met all of there requirements and My claim was submmitted they gave the go ahead approval within 2 weeks hope that helped.

[citygirl1962 50]

I am talking about getting your surgery "approved," not what makes you eligible. There are requirements for surgery but no "approval" process. Medicare also dropped its specific requirement for a 3-month supervised diet.

Edited December 6, 2015 by citygirl1962

[Bigguy9347 16]

Wow its amazing how fast things change. I just had my surgery la little over 3 weeks ago and the medicare process that I spoke of was less than 2 months previous so you are more up to date than I. AS far as the process on my part it was smooth as could be and they asked for nothing other than what my care coord. sent them. Good luck I hope it runs as smoothly as mine did.

[shangskn 2]

My husband had his surgery on Nov 23rd and had Medicare. After his last app on Nov 10th, our dr office scheduled his surgery right then and there because she said Medicare does NOT require pre-authorization. I called and made sure and it's true, no authorization needed for Bariatric surgery of any kind, it's automatically approved. ????????????

[sharowna 6]

Anyone had revision approved? Medicare pre op authorization with revision wanted?

[Pinkgirl1234 761]

Anyone had revision approved? Medicare pre op authorization with revision wanted?

There must be a need for revision other than "I want a revision "In my case my lapband was slipped and causing major internal issues.I was approved after 6 months of jumping through hoops

[JupiterinVirgo 846]

Medicare is one of the best insurances you can have for this surgery! Less pre-qualifications. No long-term pre-surgery diets. No extensive and unnecessary testing. It's cheaper to approve you faster. Once all my paperwork was submitted only took2-3 weeks for approval.