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Blue DistinctionSM Centers for Bariatric Surgery
Important Prerequisites to Bariatric Surgery
- If you are considering weight-loss surgery, meet with your physician(s)
well in advance of the surgery to develop a treatment plan and discuss
whether the surgery is appropriate for you.
- If your physician determines the surgery is medically necessary, consider
using one of the Blue Distinction Centers which Wellmark
has identified that has applied and met certain program criteria for
this procedure. Your physician
will handle the approval process for you if it is to a network provider.
- Contact Wellmark's case managers who are experienced at working with members with severe or complex medical needs, such as bariatric surgery, and provide valuable information and assistance to members pre- and post-surgery.
- Become familiar with the wealth of weight-loss resources available to
you. Checklists, tools, and information on such topics as weight-loss
alternatives, preparing for surgery, nutrition, diet, and exercise can
all be found on Healthy
Living.
Evaluation Criteria
Selection criteria for Blue Distinction Centers focused on:
- Quality of post surgical follow-up care
- Ability of clients to maintain their weight loss
- Morbidity/mortality rates
- Pre- and post-surgical education for patients and plans for follow-up care
- Appropriate equipment for management of care for morbidly obese members
- Ongoing quality management and improvement programs
- Physician and staff experience and credentials
Each of the Centers will be reviewed for compliance on an ongoing basis.
Important: Please note that although the Blue Distinction
Centers have met specific criteria and standards,
this does not imply any guarantee of a positive outcome or endorsement
by Wellmark. In addition, coverage for bariatric
surgery services is subject to all of the terms of the member's benefits
certificate or policy.
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