In the past my insurance company will deny coverage even when my primary care physician has ordered treatment for me. My doctors helped me by writing more letters to get coverage. Will that same thing happen if I ask for elective surgery?
Many HMOs and insurance companies have so many internal rules that it may seem everything requested is denied. Those internal rules are not always disclosed. Insurance representatives also vary in their responses. In some instances after several denials, your request is sent to a different insurance representative. There may be appeal processes within a particular insurance company. If your insurance is through an employer, it is helpful if you keep your employer benefits manager informed of the correspondence with the insurance company, as that person may be able to provide additional information to the insurance company that would satisfy an internal rule.
If you choose to explore whether you are a potential candidate for weight loss surgery staff is available to help you compile the information necessary for Dr. Thomas. If after evaluating that information, he determines you may be a potential candidate, he will write a letter to your insurance company setting out the reasons, and generally requests a staff to assist you communicate with your insurance company.
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