What to send in when you dr submits claim.?
Hello,
I was wondering what type of info if any I should send in the first
time my dr submits my claim. I have Health Alliance and have been on
a dr approved weight loss diet since october of 2001. That didn’t
work so now hoping to have the surgery. I know that HA covers the
surgery but didn’t want to have any snags of denial for not
submitting the right documents out there. If anyone can help me
please let me know. I have been told that they would cover the
surgery just have to send in the right documents but I don’t know
what those are and the customer service rep said she didn’t know
either.
Thanks,
Diana
March 30th, 2006 at 5:07 pm
Interesting that the customer service rep didn’t know either. It’s possible
that your surgeon will be able to get the information. I’d have his insurance
person call to find out what is required. If you go to www.obesityhelp.com ,
you will find a list of the kinds of things that are required. Usually it has
to be letter/s of medical necessity, supervised weight loss program,
co-morbidities (covered in the letter), weight over 100 lbs overweight, and
the surgeon may require a sleep test (for apnea), maybe a psyc eval, sometimes
a visit or two to a support group, etc. But all these things the surgeon’s
office will tell you. BC/BS wanted a thyroid test (I guess to be sure the
issue wasn’t something that might go away if someone took thyroid.)
Good luck!
Pam