Medicare question
After talking with Medicare, I know I meet their criteria for covering my Lap Band surgery. What concerns me is my doctor's office said they don't pre-qualify Medicare patients for surgery. I thought it had to be pre-qualified. They said they have never had a problem doing it this way. I know they are very particular! I have never seen anyone require so much documentation so perhaps this is okay but it makes me nervous to think what I would be on the line for should they refuse payment!
Can anyone tell me if this is how Medicare works on bari surgeries?
Carol
Medicare does not pre-authorize any medical services that are considered "medically necessary". I have had several surgeries that were covered by Medicare. None of them required any pre-authorization from Medicare. Therefore, I was in the "express lane" each time, meaning that all my surgeries were scheduled much sooner than if others had to go through all those hurdles with their insurance companies.
To answer your own question, I am sure that Medicare works the same way as far as WLS goes.
Vicki
DS (lap) with Dr. Clifford Deveney. Cholecystectomy (lap) with Dr. Clifford Deveney 19 months post-op.
Has not weighed myself since 1/2010. Letting my clothes gauge my progress instead.