2 Steps to get reimburse by insurance for Lap-Band surgery
Based on market research, over 80% of Lap-Band weight loss surgery were reimbursed in full or in part by insurance. However, various insurance companies have different criteria, there are 2 steps to get reimburse by insurance for lap band surgery :
Step 1 : Call to insurance company to know that is weight loss surgery a covered benefit.
The Lap-Band surgery code of Insurance companies is 43770, you can ask the ask the insurance company that is the 43770 approved?
If the Lap-Band surgery is not covered, you may need an attorney to prove the medical necessity of the procedure.
If the Lap-Band surgery is covered, proceed to next step 2.
Step 2 : Provide the documentations to the insurance company
- A referral letter from your primary care doctor that establishes a medical necessity for weight loss surgery.
- Your weight and your BMI.
- Patient history of obesity of five years or more.
- List of your medical problems associated with obesity.
- Records of medically supervised dieting.
- Documentation of your weight loss history for the past several years.
Such as the records and receipts for weight loss diet program; the receipts for the exercise equipment, gym memberships; weight loss medications and prescriptions. In short, you must prove that you had already made serious attempts to lose weight, but it is failed. - Psychological Exam
You need have a evaluation to establish your psychological condition is stable by your doctor.
Generally, the insurance company will take anywhere from 4 to 6 weeks to respond to this request. If you are approved, congratulation! You can proceed to the preparation stage of lap band surgery. If you are denied, you do have the opportunity to appeal their decision which could take a lot of time.