Not all insurance benefit plans cover all health care services. It is important
to contact your benefit plan representative to find out what your insurance
covers and what your financial obligations are as early in the process
as possible, including before your first visit. Every insurance company
has different requirements for bariatric surgery and every insurance policy
has varying amounts of coverage, co-pays and deductibles. It is important
to know exactly what your policy both requires and will financially cover
before beginning the program.
There is a toll free telephone number located on the back of your insurance
card. Please call the customer service or member services department listed
on the back of your card to find out whether or not your insurance covers
a particular health service or procedure you are having. If you do not
have coverage for those services, you may be held responsible for a portion
of or in some cases, the entire bill.
You will need the following information when you call:
Your member number
Diagnosis code of morbid obesity: ICD 10 E66.01
Procedure code:
CPT code 43775 for sleeve gastrectomy
CPT code 43644 for gastric bypass
Check your IN-NETWORK coverage: An “in-network provider” is
a provider that is contracted with the health insurance company to provide
services to plan members. It’s important to verify Dr. Hanisee is
in your network. If Dr. Hanisee is not in your network, your insurance
company will not cover your visits.
Check your OUT of NETWORK coverage: An “out-of-network provider”
is a provider who is
not contracted with the health insurance plan. If you use an OUT of NETWORK
Provider you will have a higher financial obligation and may be responsible
for the entire bill.
If you require additional assistance regarding your in-network benefits,
out-of-network benefits, whether your provider is in-network or out-of-network,
what procedures are covered and not covered, and what procedures need
to be authorized, please contact your insurance company directly.
Please note: Most insurance companies require you to have documentation
of uninterrupted 3-6 months supervised medical weight management, in addition
to other requirements. Your insurance information cannot be submitted
for authorization until we have all documents required by the surgeon
and the insurance company.
.jpg)
