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Re: Insurance HELP!

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Echo:

A word of caution from someone who works for Verizon: Many of these large

corporations are self-insured and therefore the healthcare providers are

only administrators of the plan. The plan description is specific to that

large corporation and therefore may not have the same coverage as say

someone else with Kaiser in the same city. Call the insurance company

(benefit office) and ask general questions ask them if someone was Morbidly

Obese (treatment code 278:01) (BMI 40+) and have XYZ co-morbidities and had

the recommendation from their PCP and surgeon what other requirements would

they need and under what specific circumstances cover WLS. The CPT codes

for RNY= 43846, DS =43847. My cheap plan for the management staff that is

administered by Aetna would not cover any WLS. Fortunately, my husband's

plan covered me. You need to find out what the various plans will cover.

If you have not chosen coverage you have the right to make an inquiry as to

what they will cover.

Good luck to you.

Kathie from MD

Insurance HELP!

> Hey, ya'll!

> I really need some help about my insurance! Does ANYbody know of

> anyone who works for BellSouth who has been approved for this

> surgery? (the DS)

> OR anybody who has been approved by any of these insurance companies:

> Blue Cross/ Blue Shield of Alabama

> Kaiser Permanente HMO

> United HealthCare EPO

>

> These are our 'choices' for insurance coverage and if I can find a

> precedence, I would have a better chance at gaining approval myself.

> (no pun intended)

>

> Thanks in advance for any and all help!

>

> Echo

>

>

>

> ----------------------------------------------------------------------

>

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Echo,

I was approved from United Healthcare POS, with no problems at all. My

insurance started in January, and I had surgery in April.

Kim B.

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In a message dated 07/07/2001 12:16:11 PM Central Daylight Time,

echo98@... writes:

<< Does ANYbody know of

anyone who works for BellSouth who has been approved for this

surgery? (the DS)

OR anybody who has been approved by any of these insurance companies:

Blue Cross/ Blue Shield of Alabama >>

I have BCBS of Ala thru Bell South- my husband's employer. They have denied

the DS as " investigational " . I appealed and they still denied it. However,

they did send a letter saying they would cover the Roux-En-Y. I can either

hire Walter Lindstrom and fight it (with uncertain results), or I can settle

for the RNY. I haven't made up my mind yet. I know a lot of people who are

happy with their RNY.

Cindy W in MS

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