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Re: gobo/Regence

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> I need some help.

> I need to know what the web site was that you found the info

> for " Regence policies on Morbid Obesity " . I have Regence >

> BC/BS of Oregon and am fighting their policy exclusion of

> ANYTHING to do with MO.

Hi ;

Happy to oblige. Oddly they identify the DS and give the specifics

of how it must fit their criteria, but then is the next paragraph

they state that the DS 'might' be considered experimental. I have

a feeling the way it will shake down is that they will try to get you

to go for the R-n-y and then you will have to prove to them why

you must have the DS and not the R-n-y.

Here it is:

http://www.regence.com/trgmedpol/surgery/sur58.html

Medical Policy Manual

Topic: Surgery for Morbid Obesity

Date of Origin: January 1996

Section: Surgery

Policy No: 58

Revised/Effective Date: January 18, 2001

Next Review Date: October 2002

The first treatment of morbid obesity is obviously dietary and life

style changes. Although this strategy may be effective in some

patients, frequently the weight loss is not durable, with only

5%-10% of patients maintaining the weight loss for more than a

few years. When conservative measures fail, some patients may

consider surgical approaches.

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