Insurance approval is often a lengthy and complicated process. The staff at the Clarian Bariatrics will assist you in obtaining insurance approval. However, they cannot act on your behalf since you are the policyholder. Therefore, you will need to work with our staff and remain active in the process.
Below are some steps you can take to ensure you have the best chance of obtaining coverage:
Below are some steps you can take to ensure you have the best chance of obtaining coverage:
- Read your insurance booklet and/or speak to the insurance company prior to making any appointment for surgery. The insurance company is required by law to provide you with this information.
- Look at the section called "Exclusions."
- It must say "surgery," not just "weight loss," for it to be eliminated as an option.
- If you are required to obtain a referral prior to speaking with a specialist, contact your primary care physician and request a referral prior to attending your first appointment. It is always a good idea to consult with your primary care physician anyway, as his or her support is very helpful in the process.
- Locate your past medical records. Many companies require proof that you have tried other methods of weight loss prior to seeking surgery.
- If you keep good records, including receipts, bring those to your appointment. They can be used as verification of your attempts.
- A complete record of your health history must be sent to the insurance company, and your physician must also review that history to make the appropriate decision regarding your case. Therefore, be sure to complete all paperwork and answer all questions as completely as possible.
- A full description of all your health conditions, including records of treatment, medications taken and documentation of the effects these conditions have had on your everyday life is necessary
- A detailed description of the limitations your excess weight places on your daily activities, such as walking, tying shoes or maintaining personal hygiene is helpful.
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