First Submittal Denied
I just heard from my Primary Doctor that my first attempt to get my Care Plus Insurance to approval for the Realize Band was denied. Patty at Dr/R's office then talked to them saying that my Primary Doctor needs to submit to them NOT my Surgeon's office.
We'll I called Care Plus and their stating that Laparoscopic Banding is Not a Covered Surgery, paid by Medicare (my Primary Insurance).
Which I looked up on www.medicare.gov Under Bariatric Surgery and it states " it's a viable option for many Morbidly Obese patients" per CMS Administrator Kerry Weems. That Medicare/CMS covers 4 types of bariatric surgery procedures: gastric bypass-open & laparoscopic, laparoscopic adjustable gastric banding and open & laparoscopic biliopancreatic diversion w/ duodenial switch.
So now I'm waiting to hear from my Primary Doctor, whose already started on her own Appeal Letter
We'll I called Care Plus and their stating that Laparoscopic Banding is Not a Covered Surgery, paid by Medicare (my Primary Insurance).
Which I looked up on www.medicare.gov Under Bariatric Surgery and it states " it's a viable option for many Morbidly Obese patients" per CMS Administrator Kerry Weems. That Medicare/CMS covers 4 types of bariatric surgery procedures: gastric bypass-open & laparoscopic, laparoscopic adjustable gastric banding and open & laparoscopic biliopancreatic diversion w/ duodenial switch.
So now I'm waiting to hear from my Primary Doctor, whose already started on her own Appeal Letter
Open RNY 5/10/06 and now
Laparoscopic Realize Banding. 4/21/09
9/1/09 I've rec'd 4 fills and lost 86 lbs. so far.
Check the www.obesitynomorefl.com Website Calender.
Laparoscopic Realize Banding. 4/21/09
9/1/09 I've rec'd 4 fills and lost 86 lbs. so far.
Check the www.obesitynomorefl.com Website Calender.
Hi Michael,
I am just curious, your post states that you had open RNY in 05/06 and now you are trying to get the Realize band approved. Did your RNY not work properly or what happened that you are now trying for the band? And how will it work after having an RNY? I'm sorry if I seem to be prying, I am just curious as to how this works? Thanks for the responce.
Good Luck!
Chris V.
I am just curious, your post states that you had open RNY in 05/06 and now you are trying to get the Realize band approved. Did your RNY not work properly or what happened that you are now trying for the band? And how will it work after having an RNY? I'm sorry if I seem to be prying, I am just curious as to how this works? Thanks for the responce.
Good Luck!
Chris V.
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