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List current medication s 5. Clinical records that support a body mass index BMI of 40 or greater or a BMI of 35-40 when there is at least one co-morbidity related to obesity. In. BMI If the patient s BMI is between 35. 0 and 40. 0 please be sure to include documentation of treatment/management of the member s comorbid conditions e.g. medications c-pap etc. 4. Patient must be 18 years or older. GEHA does not offer any benefit or authorize bariatric surgeries for patients 18 or under....
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What is bariatric pre-authorization?
Bariatric pre-authorization is a process where an insurer reviews and approves a bariatric surgery before the procedure is performed to determine coverage.
Who is required to file bariatric pre-authorization?
The healthcare provider or facility performing the bariatric surgery is required to file the pre-authorization.
How to fill out bariatric pre-authorization?
The healthcare provider or facility will need to fill out the pre-authorization form with all necessary patient and procedure information, and submit it to the insurer for review.
What is the purpose of bariatric pre-authorization?
The purpose of bariatric pre-authorization is to ensure that the bariatric surgery meets the criteria for coverage and to prevent unnecessary costs.
What information must be reported on bariatric pre-authorization?
Information such as patient's medical history, diagnosis, proposed procedure, surgeon's credentials, and expected outcomes must be reported on bariatric pre-authorization.
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