horizon blue cross weight loss surgery requirements

HORIZON BLUE CROSS WEIGHT LOSS SURGERY REQUIREMENTS PROFESSIONAL

HORIZON BLUE CROSS WEIGHT LOSS SURGERY REQUIREMENTS PROFESSIONAL

Professional care provided at Preferred facilities by Non-preferred radiologists, anesthesiologists, certified registered nurse anesthetists (CRNAs), pathologists, emergency room physicians, and assistant surgeons.Medical emergency or accidental injury care in a hospital emergency room and related ambulance transport as described in Section 5(d), Emergency Services/Accidents.Please refer to Section 4, Your Costs for Covered Services, for related benefits information. In addition, we must approve certain types of care in advance. You must use Preferred providers in order to receive benefits, except under the situations listed below. Transplant services related to the above listed transplants, see page 71įor more information or to locate a Blue Distinction Center, visit to use our National Doctor & Hospital Finder, or call us at the customer service telephone number listed on the back of your FEP Blue Focus ID card.Blood or marrow stem cell transplants (adult and pediatric), see pages 67- 69.Single, double, or lobar lung transplant (adult only).Pancreas pancreas transplant alone pancreas after kidney simultaneous pancreas-kidney (adult only).Liver (adult and pediatric liver alone adult only for simultaneous liver-kidney).The following transplants must be performed at a Blue Distinction Centers for Transplants: Biliopancreatic bypass with duodenal switchīlue Distinction Centers for Transplants ®īlue Distinction Centers for Transplants are selected based on their ability to meet defined clinical quality criteria that are unique for each type of transplant.

Laparoscopic adjustable gastric banding.To locate a Blue Distinction Center, visit to use our National Doctor & Hospital Finder, or call us at the customer service telephone number listed on the back of your FEP Blue Focus ID card.īenefits for bariatric surgery are limited to the procedures below and must be performed in a Blue Distinction ® Specialty Care Center for Bariatric (weight loss) surgery and must meet the requirements indicated on pages 62- 63. If you are considering covered cardiac procedures, cancer care, knee or hip replacement, or spine surgery, you may want to consider receiving those services at a Blue Distinction Center. Bariatric and Transplant care benefits are limited to services provided in a Blue Distinction Center (see pages 62 and 66).

Horizon blue cross weight loss surgery requirements