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Prior Authorization Request FormBariatric Surgery BSC Mail:BSC Fax: (844) 8078997P. O. Box 629005 El Dorado Hills, CA 957629005View our Medical Policy online at http://www.blueshieldca.comNotice:
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How to fill out weight loss surgery

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To fill out weight loss surgery, follow these steps:
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Consult with a healthcare professional or a weight loss surgeon to determine if you are a suitable candidate for weight loss surgery.
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Follow any pre-surgery diet or exercise plans provided by your healthcare team to help prepare your body for the procedure.
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Weight loss surgery, also known as bariatric surgery, is a surgical procedure used to help individuals lose weight and improve health.
Individuals who have undergone weight loss surgery are required to report the procedure to their healthcare provider and insurance company.
To fill out weight loss surgery information, individuals should provide their healthcare provider and insurance company with details of the procedure, including date, type of surgery, and any complications.
The purpose of weight loss surgery is to help individuals achieve significant weight loss, improve obesity-related health conditions, and enhance overall quality of life.
Information that must be reported on weight loss surgery includes the date of the procedure, type of surgery performed, any complications or side effects experienced, and follow-up care received.
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