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You have completed your analysis on gastric bypass surgery, and determined whether your insurance company will probably pay for the task. You've the CPT/ICD-9 codes memorized, and youre on a basis with the member companies representative at the insurance provider. You've prepared the paperwork required by your service, and the special day is finally here: Its time to publish all these records with an obtain pre-approval of one's gastric bypass procedure. 

Boost Your Chances of Insurance Success 

The list below might help you ensure you've received everything needed to boost your likelihood of getting preauthorizing for fat loss surgery from your insurance carrier: 

1. A letter of medical necessity from your primary care physician or even a medical expert recommending you for weight reduction surgery 

2. Doctors records of office visits recording your history of obesity (this should include documentation promoting The National Institute of Health instructions of extreme and morbid obesity) 

3. A well-documented set of any significant health issues, such as for instance hypertension or diabetes, considered a result of of extreme or morbid obesity 

4. Reveal listing of any doctor-prescribed drugs for weight loss 

5. Supporting documents related to any medically-supervised diet plans 

6. Assessment records and approval if under the care of a mental health specialist or if taking psychotherapeutic treatment, such as for example anti-depressants 

7. Records of any tests required by your insurance company and their effects 

Posting Your Request 

After confirming that you have obtained all necessary documents, the office of your gastric bypass physician or your primary care physician will likely help you in submitting a request preauthorization. It's also possible to submit the info yourself, however your request will probably be given more weight if from a doctor. 

Along with your necessary documents, the letter to your insurance company from your doctor may contain pertinent information to greatly help in the pre-approval process. This correspondence should demonstrably identify the day, your name, and the reason for the letter (e.g., request for preauthorization). Your date of delivery, insurance number, and class number should come straight away after these records, after which the body of the letter should follow. 

Making Your Case 

Within the body of the letter, your doctor should again state your name, with your age and sex, and the long-term medical problem that you are seeking insurance of treatmentin this case, severe or morbid obesity. 

The body of the letter also needs to contain your weight and height, and note that your body mass index (BMI) is excessive for the criteria of obesity. Additionally, your doctor should state demonstrably that if the weight problem continues, you'd suffer with serious health threats, resulting in a shorter life span. The following are other matters that ought to be addressed in your obtain preauthorization: 
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The specific period of time you've been in your doctors care specially to manage your obesity. 

Details of your active involvement in recommended diet or treatment remedies. Include the number of weight lost in following these suggestions and show that you've experienced ongoing weight gain after trying these plans. 

The current list of health conditions immediately caused by weight issues, and assurance these issues would increase considerably upon reducing the excess weight following gastric bypass surgery. 

The procedure expected to take place, the surgeon be prepared to execute the procedure, the address and telephone number of the surgeon or bariatric treatment center, and the expected length of hospital stay. 

A description of the surgery, including details of the huge benefits you seek to achieve from gastric bypass surgery. 

Prior to sending the request, be sure to create copies yourself and your personal doctor or surgeon, and fix all supporting documentation. You might also desire to deliver your letter via registered or certified mail, so you can indicate the date as soon as your request was submitted and have evidence that it was received.