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Weight Loss Surgery – Insurance Coverage Criteria

In Insurance and Costs, Pre-approval Process, Resources by OC Staff

The list below is organized by insurance company. We include the following important information for each insurance company listed: Which weight loss surgeries are covered. Required criteria before gastric bypass, Lap Band or other procedures are approved for coverage. If Lap Band fills are covered after surgery. Contact information for your insurance provider. A link to the insurance policy detailing …

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Medically Supervised Weight Loss Programs

In Insurance and Costs, Pre-approval Process by OC Staff

There is a good chance you will be required to take part in a medically supervised weight loss program. What does this mean? You will probably have to take part in a total weight loss program that will include, exercise, diet, and/or medication. Some insurances require this to be supervised by a physician other than your surgeon. The purpose of …

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How to Appeal When Insurance Denies Bariatric Surgery

In Insurance and Costs, Pre-approval Process by OC Staff

Its very possible that your insurance company denied your first request for coverage of bariatric surgery. This is often true even if your insurance company specifically has a policy to cover weight loss surgery for qualifying patients. In fact, some surgeons suggest that as many as 40% of patients have to appeal their insurance company’s initial denial before the company …

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Letter of Medical Necessity

In Insurance and Costs, Pre-approval Process by OC Staff

The Letter of Medical Necessity is required by every insurance company prior to obesity surgery. The Letter of Medical Necessity says that you are morbidly obese, according to the NIH guidelines or the guidelines that your insurance company lays out. Because you are morbidly obese it is then a medical necessity to have this procedure. Being morbidly obese is life-threatening …

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What is a Weight Loss Seminar? Do I Need To Attend?

In Insurance and Costs, Pre-approval Process by OC Staff

Weight Loss Seminars are typically held monthly but bigger bariatric surgery practices will hold seminars weekly or even every few days. Weight Loss Seminars are a low-pressure way to meet a surgeon and find out more about bariatic surgery. A good weight loss surgery seminar will include the following: An overview of all obesity surgery procedures Lap Bands Laparoscopic Gastric Bypass …

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What is a Comorbidity?

In Before Surgery, Insurance and Costs, Pre-approval Process by OC Staff

A comorbidity is a disease that is the result of, or strongly related to, a primary disease. As it applies to weight loss surgery, the disease is morbid obesity and the comorbidities are many. Morbid Obesity is a condition when you are severely overweight. Body Mass Index (BMI) is a calculation that uses your height and weight to create a …