Any luck with insurance coverage

[Ruby22 0]

Hi, I am wondering if anyone has had any luck getting the ESG procedure covered by insurance? Even better if you have experience with CareFirst BlueChoice. I have called them to ask about coverage and no one has an answer since it is not considered surgery. I also have not been able to find out what codes may be used for billing, as they said they could look into it that way.

Thanks!

[New To This23 102]

So I do not have that insurance, but what I could find was that they do cover a variety of options here is a link.

https://secure.compliance360.com/Common/ViewUploadedFile.aspx?PD=PbRt%2bA78MS7DkR7t3eswzx4PmIfqMh5Gvr16ARj2%2bYR%2fbM3Br19IKOL7BmMQvCh%2bObdTwt55hbmBERTk8pGaqPegW8FFx95O2WGDad%2fP32wtK%2fLy3eAuPemfjKVE4PNzPcJl4Diuz13mj3pVztiXT1jOk1QXXnxshbN53Oyornctpycy8rUdp6PO01yKHuAyjToezDSmtv7QFcCDCBNlPkza0BIOxIDU2F3sAcfC9iWbTygtlPuPosN%2b0KsA3MMUlStY4KrcPnrna%2fEhFWHpkpUaKhgyCBBOFWIbN6dlv9A%3d

[Ruby22 0]

On 9/5/2023 at 9:15 PM, New To This23 said:

So I do not have that insurance, but what I could find was that they do cover a variety of options here is a link.

https://secure.compliance360.com/Common/ViewUploadedFile.aspx?PD=PbRt%2bA78MS7DkR7t3eswzx4PmIfqMh5Gvr16ARj2%2bYR%2fbM3Br19IKOL7BmMQvCh%2bObdTwt55hbmBERTk8pGaqPegW8FFx95O2WGDad%2fP32wtK%2fLy3eAuPemfjKVE4PNzPcJl4Diuz13mj3pVztiXT1jOk1QXXnxshbN53Oyornctpycy8rUdp6PO01yKHuAyjToezDSmtv7QFcCDCBNlPkza0BIOxIDU2F3sAcfC9iWbTygtlPuPosN%2b0KsA3MMUlStY4KrcPnrna%2fEhFWHpkpUaKhgyCBBOFWIbN6dlv9A%3d

Hi! Thank you, I cannot get that link to work, can you share more info?

[New To This23 102]

From what I remember they cover all obesity-related surgeries, but I do not remember ESG being on the list specifically. I also think that members in Virginia had fewer hoops to jump through than members in DC and Marylin. This is from the CareFirst site.

Blue Distinction® Specialty Care

The hospital you select can have a direct impact on the care you receive and your procedure results, but finding the right facility can sometimes be a challenge. The Blue Distinction Specialty Care recognition program identifies health care facilities with proven expertise in delivering specialty care. There are two designations:

• Blue Distinction Centers - Health care facilities recognized for expertise in delivering specialty care.
• Blue Distinction Centers+ - Health care facilities recognized for expertise and cost efficiency in delivering specialty care.

Blue Distinction focuses on high-volume, high-risk and high-cost areas of specialty care, including:

• Bariatric Surgery centers provide a full range of bariatric surgical care services, including inpatient care, post-operative care, follow-up and patient education.

Edited September 18, 2023 by New To This23
Adding info

[Nikki_p 0]

On 9/18/2023 at 8:00 AM, New To This23 said:

From what I remember they cover all obesity-related surgeries, but I do not remember ESG being on the list specifically. I also think that members in Virginia had fewer hoops to jump through than members in DC and Marylin. This is from the CareFirst site.

Blue Distinction® Specialty Care

The hospital you select can have a direct impact on the care you receive and your procedure results, but finding the right facility can sometimes be a challenge. The Blue Distinction Specialty Care recognition program identifies health care facilities with proven expertise in delivering specialty care. There are two designations:

• Blue Distinction Centers - Health care facilities recognized for expertise in delivering specialty care.
• Blue Distinction Centers+ - Health care facilities recognized for expertise and cost efficiency in delivering specialty care.

Blue Distinction focuses on high-volume, high-risk and high-cost areas of specialty care, including:

• Bariatric Surgery centers provide a full range of bariatric surgical care services, including inpatient care, post-operative care, follow-up and patient education.

Thank you!