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PreAuthorization (PA) Request Form Preferred: Fax form and relevant clinical documentation to (651) 6622810 Or mail to: Utilization Management, P.O. Box 64265, St. Paul, MN 55164 Please refer to current

How to fill out bariatric surgery medical policy

How to fill out bariatric surgery medical policy

1. Obtain the necessary medical policy forms from the insurance provider.
2. Familiarize yourself with the specific requirements and guidelines for filling out the bariatric surgery medical policy.
3. Begin by entering the patient's personal information, including their full name, date of birth, and contact details.
4. Provide a thorough medical history for the patient, including any pre-existing conditions, previous surgeries, and current medications.
5. Include detailed information about the patient's weight and BMI (Body Mass Index), as well as their weight loss attempts and outcomes.
6. Attach relevant medical records and documentation, such as lab results, imaging reports, and notes from healthcare professionals.
7. Complete the section on the proposed bariatric surgery, including the type of procedure, surgeon's information, and desired outcome.
8. Include any additional supporting documentation, such as psychological evaluations or dietary assessments.
9. Review the completed medical policy form for accuracy and completeness.
10. Submit the filled-out bariatric surgery medical policy to the insurance provider, ensuring all required documents are included.
11. Follow up with the insurance provider to ensure the submission is received and to inquire about the status of the policy approval.

Who needs bariatric surgery medical policy?

1. Individuals who meet specific criteria and are diagnosed with severe obesity, typically with a Body Mass Index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related medical conditions may need bariatric surgery medical policy.
2. Candidates for bariatric surgery may have tried other weight loss methods without success and may have significant health risks associated with obesity, such as diabetes, hypertension, sleep apnea, or joint problems.
3. It is important for individuals considering bariatric surgery to consult with healthcare professionals, such as their primary care physician or a bariatric surgeon, to determine if they meet the requirements and would benefit from this type of surgery.

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What is bariatric surgery medical policy?

Bariatric surgery medical policy outlines the criteria and guidelines for the coverage of weight-loss surgeries, including the eligibility requirements for patients and the types of procedures covered by insurance providers.

Who is required to file bariatric surgery medical policy?

Healthcare providers and facilities that perform bariatric surgeries, as well as insurers who cover such procedures, are required to file and maintain adherence to the bariatric surgery medical policy.

How to fill out bariatric surgery medical policy?

To fill out a bariatric surgery medical policy, providers must gather the patient's medical history, document the reasons for surgery, provide evidence of attempts at weight loss, and complete the specific forms required by the insurance company.

What is the purpose of bariatric surgery medical policy?

The purpose of bariatric surgery medical policy is to ensure that patients receive appropriate evaluation for weight-loss surgery, to guide insurers in making coverage decisions, and to maintain a standard of care in the management of obesity.

What information must be reported on bariatric surgery medical policy?

Information that must be reported includes patient demographics, medical history, body mass index (BMI), documented attempts at weight loss, psychological evaluations, and the specific surgical procedure proposed.