Certification Vs. Precertication

I am applying for Medicare and I was wondering what is the difference between Precertification and Certification for having DS surgery. Is it easier to be approved by medicare if a precertication exists. I also heard several people talk about Centers of Excellence, does this mean that the Dr. which operates there are the best in the business? Thanks.... Sue

Hi Sue, I wish this were an easy one to explain. I've done some editing for a bariatric journal and a BR newsletter, so I've done some reading on it lately. There are two different groups certifying hospitals and surgical groups as "centers of excellence." One is the American Society for Bariatric Surgery (ASBS) and the other is the American College of Surgeons (ACS). In both cases, the center of excellence signification is most important because the Medicare program will only fund surgeries at COEs. The COE have to meet surgical requirements and they are indeed excellent, but they also have made an agreement based on compensation and costs. Surgeons and hospitals must also pay to have the COE destination. http://www.surgicalreview.org/pcoe/tertiary/TertiaryFeeStructure.aspx For this reason, other surgeons feel that the COE requirement puts low-cost over the patient needs. It's a debate, of course, and there are lots of sides to it. Your facility in Lafayette is one of I think four in the state with the COE distinction. The surgeons must qualify and agree to the terms separately and Dr. Chu is also a COE surgeon. Here's the SRC list for Louisiana: http://www.surgicalreview.org/locate.aspx?state=LA#srchResults Here's a excerpt from a Bariatrics Today article by Dr. Terry Simpson: While ASBS does have a lock on the majority, its Centers of Excellence program is not the only one; the American College of Surgeons (ACS) also has an outstanding program. Still, the ASBS attempted to put pressure on the ACS to scrap their program and go with the ASBS (SRC) version. Of the two organizations, the larger and more prestigious ACS has the clear track record in dealing with outcomes research and development, not ASBS. Still, outcomes research is necessary and important. Pushing aside years of work and expecting surgeons who have been quietly working in the field to join the chorus that this is new and different, and accepting that the steps taken by Medicare to give this new group a monopoly, however, smacks not of science, but of politics. ...and of course, I did mention is was all 'debateable.' I hope this helps, Frances

Thanks Frances, the information you gave was superb and it definitely gives insight into the different Bariactic groups. Thank you very much. Sue