Blue Care Network Bariatric Surgery Requirements

A body mass index of 40 or greater.

Blue care network bariatric surgery requirements.

Bariatric surgery released june 2017. We are proud and thankful to be recognized by blue cross and blue shield of illinois and to be part. The facility must meet all requirements in table 3 to meet the quality evaluation portion of the eligibility decision. 18 to 65 years of age.

Your blue cross insurance policy covers weight loss surgery unless it states specifically that it excludes it. You need must be between the ages of 18 and 60 years old. Bcn is responsible at its cost to respond to and to defend claims seeking the provision of benefits or the payment of medical expenses. Cost of care blue plan healthcare claims data.

Bcbs of michigan provides full coverage for bariatric procedures provided the patient meets the following requirements. Quality specialty care in the areas of bariatric surgery cancer care cardiac care. Blue distinction centers for bariatric surgery. Facility participation prelim 10 facility is a participating provider with its local blue plan ppo network required subspecialists 14 proportion of the bariatric surgical care providers and or provider groups i e anesthesiologists.

Blue care network uses third party administrators to process claims. Bcn members are not required to have their bariatric surgery performed at a blue distinction center. The documentation that is required by blue care network in order to proceed with the medical determination about whether the initial referral will be approved. Tenncare does cover weight loss surgery for those individuals that meet certain criteria.

Funding and disclosures supported by blue cross blue shield of michigan and blue care network. For tenncare to cover your weight loss surgery the following are required. In order to be pre approved for the procedure you must meet the following requirements. In 2011 tenncare adopted the guidelines that blue cross blue shield uses for bariatric surgery.

Ambulatory surgery center designation. Our third party administrators do not ensure that any medical expenses of individuals covered by bcn will be paid. Requests for bariatric surgery for patients under 18 years of age should.