Resources and Information
Resources and answers to many of your questions are included below.
Bariatric Surgery Resources
To find out more about this highly effective surgery, visit:
- American Society for Metabolic and Bariatric Surgery/Surgical Review Corporation at www.surgicalreview.org
- The American College of Surgeons: Bariatric Surgery Center Network at www.acsbscn.org/Public
- MyHumana
- Emmi Solutions creates web-based communication solutions that engage patients across the continuum of care www.my-emmi.com
Information about Bariatric Surgery Benefits
Contact us to find out what benefits are covered under your plan, including:
- Types of bariatric surgery Humana covers
- Medical necessary criteria
- Whether coverage includes travel benefits
- What's included under travel benefits
How Humana's Bariatric Management Team Can Help
Humana's Bariatric Management team guides members through the entire bariatric process:
- Benefits explanation
- Review of bariatric surgery medical necessity criteria
- Types of bariatric surgeries covered under the member's plan
- Guidance in selecting a bariatric surgeon and a Humana-preferred facility that is a Bariatric Center of Excellence
- Pre-surgery educational video modules
- The surgery pre-determination process
Members eligible for the Bariatric Management Program receive six months of bariatric care management after their operation as well as post-surgery educational video modules.
Pre-determination Requests
Your surgeon faxes or e-mails your clinical information to Humana's bariatric management team requesting an authorization for surgery. The bariatric nurse reviews the clinical information as well as provider and hospital Bariatric Center of Excellence status. The bariatric nurse assures the medical necessity criteria has been met and, if necessary, consults with the bariatric regional medical director.
HMO Plan Issues
Your health maintenance organization (HMO)'s Primary Care Physician (PCP) can send your referral for bariatric surgery to the bariatric management team, who will enter it into the Humana System. Your PCP will also need to send a copy to the surgeon's office.
Claims Questions
For billing questions, mail your question/concern to Humana Claims, P.O. Box 14610, Lexington, KY 40512-4610 or call the customer service number on the back of your Humana ID card
Contact Us
Phone: 1-866-486-5295
E-mail: bariatrics@humana.com
Fax: 1-502-508-0049
