Dr K. M. MacKenzie MD.
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316 W. Acequia,
Visalia,
CA 93291.
Phone: 559.733.9900
Fax: 559.733.9903
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 Insurance Questions

Q. What are the insurance requirements for bariatric surgery?

A. Every insurance company has its own rules for approving payment for bariatric surgery so you will need to check with your insurance company for their specific guidelines. In general, you can expect the guidelines to be similar to the following:

  • Medical records from the previous six-months, relating to the patient evaluation and treatment to date, including diagnostic lab-work (must include glucose and thyroid studies). The testing done should have been performed within the previous six months.
  • A detailed history that includes co-morbidities.
  • A psychological/psychiatric evaluation that documents patent understanding of the procedures and needed follow-up care.
  • the surgical approach and any additional procedures requested including a post operative follow up plan that includes nutritional and psychological support, weight, exercise and diet monitoring.
  • documentation of current height, weight and BMI
  • Six months of documented exercise regimen (include dates and results)
  • Six months of physician - dietician monitored diet program (include dates and results)
  • Physician verification that patient is a minimum of 100 pounds above the weight indicated by federal guidelines.

 

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K. M. MacKenzie, MD. Inc.a surgical weight management practice specializing in Lap Band surgery with complete pre and post operative management and support to the residents of Central California and surrounding areas. Karen MacKenzie, MD. is a general and bariatric surgeon dedicated to providing minimally invasive surgical procedures to morbidly obese patients.

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