Get the free Bariatric Surgery Preauthorization Form - Innovative Care ...

PO Box 22386, Portland, OR 97269 Internet Site: HTTP: www.innovativecare.com Telephone: (503) 654-9447 Fax: (503) 654-8570 Toll Free: 1-800-862-3338 Healthcare savings and satisfaction through innovation

How to fill out bariatric surgery preauthorization form

Who needs bariatric surgery preauthorization form?

1. Individuals who are planning to undergo bariatric surgery may need to fill out a preauthorization form. This form is typically required by insurance companies in order to determine coverage for the procedure.
2. Patients who have chosen a specific bariatric surgeon or hospital may also need to submit a preauthorization form. Different healthcare providers have varying requirements, so it's important to contact the chosen surgeon or hospital to confirm if this form is necessary.

How to fill out a bariatric surgery preauthorization form:

1. Obtain the form: Contact the insurance company or healthcare provider to request the bariatric surgery preauthorization form. It is commonly available on their website or can be sent by mail.
2. Personal information: Fill in your personal details accurately, including full name, date of birth, address, phone number, and insurance information. Make sure to double-check the accuracy of this information to avoid any delays in processing.
3. Medical history: Provide a detailed medical history, including any pre-existing conditions, previous surgeries, medications, and any relevant medical information. It is crucial to be thorough and provide accurate information to facilitate the preauthorization process and avoid any potential complications.
4. Surgeon and hospital information: Include the complete details of the chosen bariatric surgeon and the hospital where the procedure will be conducted. This often includes their names, addresses, phone numbers, and any other specified information requested on the form.
5. Bariatric surgery information: Provide comprehensive information about the proposed bariatric surgery, such as the specific surgical procedure, anticipated surgery date, rationale for the surgery, and any additional necessary documentation such as medical reports or letters from healthcare professionals.
6. Supporting documentation: Attach any required supporting documentation, such as medical records, previous test results, specialist referrals, or letters of recommendation. These documents can strengthen the preauthorization request and improve the likelihood of coverage approval.
7. Review and submit: Carefully review the completed form for any errors or missing information. Ensure that all sections have been accurately filled out before submitting the form. It is advisable to make a copy of the completed form for personal records.
8. Follow up: After submitting the preauthorization form, it is recommended to contact the insurance company or healthcare provider to confirm receipt and inquire about the expected processing time. Keep track of all communication, including dates and names of representatives spoken to, in case any further follow-up is necessary.

It is important to note that the specific requirements and process for filling out a bariatric surgery preauthorization form may vary depending on the insurance provider or healthcare facility. Therefore, it is always recommended to consult with the insurance company directly or seek guidance from the chosen bariatric surgeon to ensure accurate completion of the form.

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What is bariatric surgery preauthorization form?

The bariatric surgery preauthorization form is a document that needs to be submitted to the insurance company prior to undergoing weight loss surgery.

Who is required to file bariatric surgery preauthorization form?

Patients who are planning to undergo bariatric surgery are required to file the preauthorization form.

How to fill out bariatric surgery preauthorization form?

The bariatric surgery preauthorization form can be filled out by providing all necessary personal and medical information, as well as details of the planned surgery.

What is the purpose of bariatric surgery preauthorization form?

The purpose of the bariatric surgery preauthorization form is to obtain approval from the insurance company for the weight loss surgery.

What information must be reported on bariatric surgery preauthorization form?

The bariatric surgery preauthorization form must include personal information, medical history, details of the planned surgery, and any supporting documentation.