Federal bcbs bariatric surgery requirements
WebJun 19, 2015 · BMI: 30.4. Posted June 20, 2013. Hi! I'm new to this entire process. I've been doing lots of research on the VSG and I feel it is my best long-term, weight loss option. I … Web1 This facility indicated voluntarily that Radiologists, Anesthesiologists, Pathologists, Hospitalists, and Intensivists who provide services for elective (scheduled) procedures related to this Blue Distinction Specialty Care program are in the local Plan's BlueCard PPO network. 2 This is a freestanding surgery center that performs outpatient ...
Federal bcbs bariatric surgery requirements
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WebProgram Selection Criteria for Bariatric Surgery (PDF) Cancer CARE Blue Distinction Centers for Cancer Care provide a full range of cancer services. These Centers have a demonstrated focus on delivering quality and value through patient-centered, coordinated care. Directory of Blue Distinction Centers/Centers+ for Cancer Care (PDF) WebBenefit Description Procedures to treat morbid obesity – a condition in which an individual has a Body Mass Index (BMI) of 40 or more, or an individual with a BMI of 35 or more with one or more co-morbidities; eligible members must be age 18 or over and the procedure …
WebHowever, the coverage decision also specified, “CMS has determined that covered bariatric surgery procedures are reasonable and necessary only when performed at facilities that are: (1) certified by the American College of Surgeons (ACS) as a Level 1 Bariatric Surgery Center (program standards and requirements in effect on February 15, 2006 ... WebThe member must meet all requirements. Prior approval is obtained Member must be at least 18 years of age at the time prior approval is requested and the treatment plan is submitted Diagnosis of gender dysphoria by a qualified healthcare professional New gender identity has been present for at least 24 continuous months
WebThe following bariatric procedures may be considered medically necessary for the surgical treatment of morbid obesity when ALL of the patient selection criteria are met.Bariatric surgery should be performed in appropriately selected patients by surgeons who are adequately trained and experienced in the specific techniques used and in institutions … WebJun 19, 2015 · Surgery: Gastric Sleeve Height: 5 feet 5 inches Starting Weight: 225 lbs Weight Lost: 42 lbs Current Weight: 183 lbs BMI: 30.4 Posted June 20, 2013 Hi! I'm new to this entire process. I've been doing lots of research on the VSG and I feel it is my best long-term, weight loss option.
WebAug 15, 2024 · BCBS Kansas (BCBSKC) will provide coverage for weight loss surgery when it is deemed to be medically necessary because the criteria below are met. …
Web2024 STANDARD PRECERTIFICATION REQUIREMENTS –for most BCBSAZ members Provider assistance for BCBSAZ members: 602-864-4320or 1-800-232-2345 For members enrolled in eviCore precertification program: online request tool For BlueCard (out-of-area) members: 1-800-676-2583 fanny futsalWebReduction mammaplasty may be considered medically necessary for the treatment of macromastia when well-documented clinical symptoms are present, including but not limited to: Documentation of a minimum 6-week history of shoulder, neck, or back pain related to macromastia not responsive to conservative therapy, such as an appropriate support … hmdx jam hangtimeWebJun 4, 2024 · Anthem BCBS – Requirements for Weight Loss Surgery. Anthem BCBS may cover weight loss surgery as long as your policy does not specifically exclude coverage. … hmdx hangtime pairingWebJul 7, 2024 · The answer is yes, subject to your eligibility for the BCBS federal employees program. At the same time, the state laws related to weight loss surgery insurance coverage will also apply according to the state where you reside and work. Here are some of the key requirements for this coverage. Age and BMI: You must have attained the age … h&m durhamWebFEP also covers procedures to treat morbid obesity. For members 18 and over with a BMI 40 or higher or a BMI 35 or higher with one or more comorbidities, benefits are available … hm dunn companyWebJun 21, 2024 · BCBS Florida Pre-Approval Requirements BMI of 35 or greater Diagnosed as morbidly obese for at least 5 years Documentation of physician supervised non-surgical management weight loss program (e.g., diet, exercise, drugs) for at least 6 consecutive months No thyroid or endocrine disorders Psychological evaluation fanny gamelinWebJan 24, 2024 · As a reminder, Blue Cross and Blue Shield of North Carolina (Blue Cross NC): DOES require an evaluation by a licensed/qualified behavioral health provider to document patients' suitability for the procedure. This is strictly a consultation. DOES NOT require psychological and/or neuropsychological testing as part of this pre-surgical … hmdx hx-p230 manual