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Tips for Insurance Approval



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I also have BC/BS and they are covering my surgery. All I can say is to follow the rules that they have to qualify for the coverage. My policy required me to do 6 months of nutrition visits, which I found helpful (I didn't want to do them at first). You also have to meet their BMI requirements. My nutritionist told me that they want to see an effort made and make sure that they aren't putting out the money for the surgery if you are just going to go back to your old habits. Another thing I had to give as part of the prior authorization process is a listing of all the different ways (and diets) I tried to lose weight that was unsuccessful. It was hard because I don't believe in "diets". I have always believe in healthy eating. So, the financial person at my doctors office told me that since I used to go dancing a lot, to include that in my list. The hardest part was waiting for the approval, which took almost 4 weeks.

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Not really many tips, it's pretty black and white on our parts, if you meet the requirements, by law if your provider has been instructed by your employer to include the procedure in coverage, they can't turn you down. There's no picking and choosing as far as that goes. Just make sure you meet ALL requirements and you'll be fine. The person who works for your doctor who handles insurance should know what to do.

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