Federal Employee Plans
Hey Gary,
I've got a quick question if you don't mind. I have BC/BS (HMSA)Federal Employee Program, which states "Adjustable gastric banding (CPT code 43843), whi*****ludes the Lap-Band procedure, is no longer considered investigational. However, the procedure is not covered by FEP as it is not a benefit of that plan."
Now, this particular procedure IS covered through regular BC/BS (HMSA) and various other types of Gastric Bypass are covered as well under both policy guidelines. I haven't been officially turned down by the insurance company, but based on the above, it would have been a certainty. Any ideas regarding how to get around this? I realize there is an appreal process and external review board to go through, but am trying to find the most expedient method of accomplishing this.
Thanks!
Candy