Bariatric Surgery Criteria Change

January 22, 2017

Beginning with effective and renewal dates of January 1, 2017, Blue Cross Blue Shield of North Carolina (BCBSNC) members will be required to have documentation of 12 consecutive months of medical management prior to requesting Prior Authorization Approval for bariatric surgery. This does not apply to members who have received Prior Authorization Approval for bariatric surgery before the 2017 renewal date.

This is a change from BCBSNC's 2016 policy, which did not require prior medical management documentation. View full details here.

EMPLOYEE COMMUNICATION
Below is a simplified message you can use to communicate this change with your employees.

Bariatric Surgery Criteria Change

Beginning January 1, 2017, Blue Cross Blue Shield of North Carolina (BCBSNC) members seeking bariatric surgery will be required to have documentation of 12 consecutive months of medical management before requesting Prior Authorization Approval for bariatric surgery. If you received Prior Authorization Approval for bariatric surgery before the 2017 renewal date, this does not apply to you.

If you have questions, please contact Human Resources.