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 my Surgeon's office then talked to them. And CP is 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,
laproscopic 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
Care Plus Insurance to approval for the Realize Band was denied. Patty
at my Surgeon's office then talked to them. And CP is 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,
laproscopic 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.
I hope you get the surgery you want. I did not have a problem with Medicare approval. I had a list, from the surgeon, as to what Medicare required and did all the things on the list. I even called Medicare and my Plan F insurance to verifiy coverage after the hospital scheduling person called me with my date of March 5, 2009. My Plan F is Physican's Mutal, they said they always pay the 20% of the Medicare approval rate no matter what the surgery is, period.