When first introduced, the Lap Band procedure was deemed experimental and many insurance companies would not cover this weight loss surgery. Today, codes in the American Medical Association have deemed the procedure coverable by medical insurance. Even so, medical coverage is not a guarantee. It is important to build a strong case for the surgery before contacting the insurance company.
Instructions
1. Be sure that initial candidacy criteria has been met. Typically, candidates for this procedure are at least 100 pounds overweight or have a BMI that is higher than 40. In some cases, a BMI of 35 or more can qualify, but with medical conditions that result from being overweight.
2. Prepare a thorough and extensive list of documents to give to the insurance company. These documents should include: a referral letter from a primary care physician outlining a medical necessity for this weight loss procedure---any medical conditions that stem from patient obesity should be listed in this referral; any items that will indicate proof of failed attempts at weight loss---this can include receipts from companies, food and exercise journals, fitness club documents and books purchased on the subject of diet and weight loss; referrals from specialists of any condition that has resulted from being overweight (cardiologist, endocrinologist, etc.).
3. Do not become discouraged if the first attempt at coverage fails. Sometimes, will deny initial claims based on lack of thorough information. Many people have achieved success during the appeal process of an insurance claim for this procedure. Simply work harder with the physicians to build a solid case for candidacy.
Tags: weight loss, being overweight, conditions that, from being, from being overweight, insurance companies, insurance company