Help Insurance Problems....

[BJ2CUTE 16]

Ok I just received a letter from my insurance that says Procedure code 43775 is a contract exclusion.. I have already done all my pre op test etc. So my question is has anyone had this problem and if so what was the outcome?

[ALittleMe0914 69]

I know that the procedure code 43775 is the code for the surgery itself, it sounds like your insurance plan doesn't include coverage for that specific code. Have you reached out to them? If they are denying it, usually there is an appeals process. But if your policy doesn't include coverage for Bariatric surgery you might not be able to do anything about it.

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[Sharon1964 2,530]

Get a copy of your plan's policy on bariatric surgery.

[BJ2CUTE 16]

Thanks guys my plan says 90% for bariatric procedure if I use a facility they cover. Before I even look into having the surgery I looked into this I even received a cost sheet from my Dr's office of what my cost would be. I guess that's why I don't understand. I have to wait till tomorrow to talk to Dr's office and insurance just hope all goes well. I was really nervous about having the procedure but now I'm disappointed I may not have it..

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