{"id":107,"date":"2020-03-05T13:00:00","date_gmt":"2020-03-05T13:00:00","guid":{"rendered":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/?p=107"},"modified":"2020-09-02T10:41:22","modified_gmt":"2020-09-02T10:41:22","slug":"experimental-investigational-unproven-treatment-policy-review","status":"publish","type":"post","link":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/experimental-investigational-unproven-treatment-policy-review\/","title":{"rendered":"Experimental\/ Investigational\/ Unproven Treatment Policy Review"},"content":{"rendered":"\n<p>Below I reviewed ten Experimental\/Investigational (E\/I\/U) healthcare policies. The goal here is to compare and contrast them. While very similar, there are differences in the definitions, requirements, and restrictions. I have <strong>emphasized<\/strong> issues and terms I consider important. Remember my mottos:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><em>Words<\/em>\nmatter<\/li><li><em>Specificity<\/em>\nmatters<\/li><li><em>Dates <\/em>matter<\/li><li><em>Accuracy<\/em>\nmatters<\/li><\/ul>\n\n\n\n<p>Tailoring your pre-authorization packet, documentation, and\nletters to the carrier\u2019s policy requirements and <em>verbiage<\/em> is the very best strategy to obtain pre-authorization and\nwin an appeal if denied. At the end of this document is a cut-and-paste list of\nverbiage to include generously in your pre-authorization and appeal documents.<\/p>\n\n\n\n<p><strong>Experimental \/ Investigational\n\/ Unproven Policies<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>\n  1\n  <\/td><td>\n  Anthem Blue Cross Blue Shield (lipo for lipedema approved)\n  <\/td><td>\n  11\/1\/2019\n  <\/td><\/tr><tr><td>\n  2\n  <\/td><td>\n  Allways health insurance (lipo for lipedema specifically excluded)\n  <\/td><td>\n  3\/1\/2020\n  <\/td><\/tr><tr><td>\n  3\n  <\/td><td>\n  BCBS-ND (lipo for lipedema not referenced)\n  <\/td><td>\n  Jan 1\n  2020\n  <\/td><\/tr><tr><td>\n  4\n  <\/td><td>\n  BCBS-VT (lipo for lipedema not referenced)\n  <\/td><td>\n  5\/1\/2018\n  <\/td><\/tr><tr><td>\n  5\n  <\/td><td>\n  Fallon Health (lipo for lipedema not referenced)\n  <\/td><td>\n  9\/1\/2019\n  <\/td><\/tr><tr><td>\n  6\n  <\/td><td>\n  HealthNet (lipo for lipedema not referenced)\n  <\/td><td>\n  1\/1\/2020\n  <\/td><\/tr><tr><td>\n  7\n  <\/td><td>\n  Meridian Health Plan (lipo for lipedema not referenced)\n  <\/td><td>\n  11\/1\/2015\n  <\/td><\/tr><tr><td>\n  8\n  <\/td><td>\n  Molina Healthcare (lipo for lipedema not referenced)\n  <\/td><td>\n  6\/25\/2014\n  <\/td><\/tr><tr><td>\n  9\n  <\/td><td>\n  Ventura County Health Plan (lipo for lipedema not referenced)\n  <\/td><td>\n  2\/14\/2019\n  <\/td><\/tr><tr><td>\n  10\n  <\/td><td>\n  Wellmark-BC-BS (lipo for lipedema not referenced)\n  <\/td><td>\n  2\/6\/2020\n  <\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><strong>Anthem Blue Cross\nBlue Shield<\/strong> has a published E\/I policy (2015) and a more current policy NC00009,\n<em>Cosmetic and Reconstructive Services<\/em> accepting\nliposuction for lipedema as reconstructive and medically necessary. It was effective\n11\/1\/2019.<\/p>\n\n\n\n<p>All policy decisions are at the discretion of the medical\ndirector.<\/p>\n\n\n\n<p>The Anthem policy from 2015 (outdated) includes a list of\nE\/I <strong>research quality and efficacy flaws<\/strong>.<\/p>\n\n\n\n<p><strong>***<\/strong><\/p>\n\n\n\n<p><strong>Allways Health\nInsurance<\/strong> provides coverage when the surgery or procedure is reconstructive\nin nature, i.e. needed to improve the functioning of a body part, treat an\nassociated medical complication, or is otherwise medically necessary, even if\nthe surgery or procedure may also improve or change the appearance of a portion\nof the body. Policy Date: 3\/1\/2020.<\/p>\n\n\n\n<p>Note: InterQual\u00ae Criteria Lookup\nlink [used to determine if panniculectomy is warranted.]<\/p>\n\n\n\n<p>Note: Liposuction is often an\nintegral part the surgical removal of excessive skin [panniculectomy ]; this is\nnot separately reimbursed.<\/p>\n\n\n\n<p>[Excluded are] Any procedure where the primary purpose is to\n<strong>enhance aesthetics<\/strong>, including but\nnot limited to: \u2026<strong>liposuction.<\/strong><\/p>\n\n\n\n<p><strong>General Exclusion<\/strong>:\n4. <strong>Liposuction for lipedema<\/strong> [this is\nspecifically excluded].<\/p>\n\n\n\n<p>March 2020: Annual review. <em>Added exclusion Liposuction for lipedema<\/em>. References updated.<\/p>\n\n\n\n<p><strong>***<\/strong><\/p>\n\n\n\n<p><strong>BCBS-ND<\/strong> Experimental\n\/ Investigational Revised Jan 1 2020<\/p>\n\n\n\n<p>Experimental\/Investigational services are defined as a\ntreatment, procedure, facility, equipment, drug, service or supply\n(\u201cintervention\u201d) that has been determined not to be <strong>medically effective<\/strong> for the condition being treated.<\/p>\n\n\n\n<p>Charges submitted for the services listed in this policy are\ndenied as experimental \/ investigational. The determination for denial is based\non ANY of the following reasons:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>The intervention does not have Food and Drug\nAdministration (FDA) approval to be marketed for the specific relevant\nindication(s).<\/li><li>Available\nscientific evidence does not permit <strong>conclusions\nc<\/strong>oncerning <strong>the effect of the\nintervention on health outcomes.<\/strong><\/li><li>The intervention is not proven to be as <strong>safe or effective<\/strong> in achieving an\noutcome equal to or <strong>exceeding the\noutcome of alternative therapies.<\/strong><\/li><li>The intervention does not improve health\noutcomes.<\/li><\/ol>\n\n\n\n<p>The intervention is not proven to be <strong>applicable<\/strong> <strong>outside the\nresearch setting<\/strong>. [Not applicable to the general population; find research\nsupporting this].<\/p>\n\n\n\n<p>The policy includes a long list of CPT&#x2122; codes but the\nliposuction CPT&#x2122; codes\nwere not listed.<\/p>\n\n\n\n<p><strong>***<\/strong><\/p>\n\n\n\n<p><strong>BCBS-VT<\/strong> Experimental\n\/ Investigational; makes point that the <strong>diagnosis\ncode<\/strong> will cause the denial. Policy Date: 5\/1\/2018.<\/p>\n\n\n\n<p>\u201cExperimental of Investigational Services\u201d means health care\nitems or services that are either <strong>not\ngenerally accepted<\/strong> by informed health care providers <strong>in the United States<\/strong> [perhaps omitting foreign research common in\nlipedema? &#8211; Jeff] as effective in treating the condition, illness or diagnosis\nfor which their use is proposed, or are not proven by medical or scientific\nevidence to be effective in treating the condition, illness or diagnosis for\nwhich their use is proposed.<\/p>\n\n\n\n<p>The scientific evidence must permit conclusions concerning\nthe effect of the technology on health outcomes.<\/p>\n\n\n\n<p>The evidence should consist of <strong>well-designed<\/strong> and <strong>well-conducted\ninvestigations<\/strong> published in <strong>peer-reviewed<\/strong>\njournals. The <strong>quality <\/strong>of the body of\nstudies and the <strong>consistency<\/strong> of the\nresults are considered in evaluating the evidence.<\/p>\n\n\n\n<p>The evidence should demonstrate that the technology can <strong>measure <\/strong>or <strong>alter the physiological changes<\/strong> related to a disease, injury,\nillness, or condition. In addition, there should be evidence or a convincing\nargument based on established medical facts that such measurement or alteration\naffects health outcomes.<\/p>\n\n\n\n<p>The BCBS-VT policy is 87 pages and a pretty good overview; it\nis mostly a long list of complete CPT codes<strong>.\nLiposuction not addressed <\/strong>or found in the E\/I\/U policy document.<\/p>\n\n\n\n<p>***<\/p>\n\n\n\n<p><strong>Fallon Health<\/strong>\nexcludes coverage of experimental\/investigational procedures due to their lack\nof reliable or detailed clinical evidence of <strong>superior clinical outcomes<\/strong>. Fallon\nHealth evaluates many different types of clinical evidence in determining if a\nprocedure or treatment has a <strong>greater\nsafety or efficacy<\/strong> <strong>than conventional\ntreatments<\/strong>. This is inclusive but not limited to published technological\nassessments, randomized control studies, published peer literature, and expert\nopinions.<\/p>\n\n\n\n<p>Fallon Health will evaluate available, peer-reviewed\nscientific literature in relation to an overall clinical outcome and it\u2019s\nacceptance of use in a clinical setting. <strong>Prior\nauthorization is required<\/strong> for the use of any service or procedure as\noutlined in this policy. These requests must be supported by the treating provider(s)\nmedical records. Policy Date: 9\/1\/2019.<\/p>\n\n\n\n<p>In your appeal, <strong>reference\nexperts in the field of lipedema and LS-TL<\/strong>.<\/p>\n\n\n\n<p>I would first look at the FEB 2020 liposuction for lipedema\noutcomes research paper and the list of researchers. There is no reference to\nliposuction or lipedema for their liposuction or their CPT codes in the policy.<\/p>\n\n\n\n<p>***<\/p>\n\n\n\n<p><strong>HealthNet <\/strong>E\/I\/U\nPolicy 1\/1\/2020; some Medicaid policies.<\/p>\n\n\n\n<p>Health Net considers as Experimental or Investigational if\nit meets any of the following:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>It is <strong>currently\nthe subject of active and credible evaluation<\/strong> (e.g., clinical trials or\nresearch) to determine: clinical efficacy, therapeutic value or beneficial\neffects on health outcomes, or benefits beyond any established medical based\nalternative. [this verbiage suggests to me that they could deny any procedure\ncurrently being evaluated &#8211; Jeff]<\/li><li>FDA approval.<\/li><li>The most recent peer-reviewed scientific studies\npublished or accepted for publication by <strong>nationally\nrecognized medical journals<\/strong> do not conclude, or are inconclusive in\nfinding, that the Service is <strong>safe and\neffective<\/strong> for the treatment if the condition for which authorization of the\nService is requested. safe \/ effective<\/li><\/ol>\n\n\n\n<p>Liposuction is not addressed or found in the policy document.<\/p>\n\n\n\n<p>***<\/p>\n\n\n\n<p><strong>Meridian Health Plan<\/strong><\/p>\n\n\n\n<p>E\/I\/U is any procedure, device or pharmaceutical agent that\nis <strong>still undergoing pre-clinical or\nclinical evaluation [could deny anything &#8211; Jeff]<\/strong>, and\/or has not yet\nreceived regulatory approval. It is the use of a service, procedure or supply\nthat is not recognized by the Plan as <strong>standard\nmedical care<\/strong> for the condition, disease, illness or injury being treated. A\nservice, procedure or supply includes but is not limited to the diagnostic\nservice, treatment, facility, equipment, drug or device. When basic safety and\nefficacy have been demonstrated by the experimental scientific process, the\ninvestigational phase begins. Policy Date: 11\/1\/2015<\/p>\n\n\n\n<p>Adequate evidence is defined as at <strong>least two documents<\/strong> of medical and scientific evidence that\nindicate that the proposed treatment is likely to be beneficial to the member adequate\nevidence<\/p>\n\n\n\n<p>The Meridian Health Plan is particularly detailed. I copied it\nto a separate word document.<\/p>\n\n\n\n<p>***<\/p>\n\n\n\n<p><strong>Molina Healthcare Experimental\n\/ Investigational Policy: <\/strong>no reference to any specific CPT codes or\nprocedures; Policy Date: 6\/25\/2014 (outdated)<\/p>\n\n\n\n<p>\u201cExcluded\u2026are procedures\u2026that have not successfully\ncompleted a Phase III trial\u201c<\/p>\n\n\n\n<p>Molina Healthcare Molina Healthcare defines the terms\n\u201cexperimental\u201d or \u201cinvestigational\u201d or \u201cunproven\u201d (E\/I\/U) as the use of a\ntechnology drug, device, treatment or procedure that has not been recognized as\nhaving <strong>proven benefit<\/strong> in clinical\nmedicine for any condition, illness, disease or injury being treated<\/p>\n\n\n\n<p>Molina Healthcare has <strong>five\ncriteria<\/strong>:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>FDA approval<\/li><li>Published peer-reviewed literature must\ndemonstrate the <strong>proven beneficial impact<\/strong>\nof the service\/procedure on health outcomes for the given indication.<\/li><li>Published <strong>peer-reviewed\nliterature<\/strong> must demonstrate that the technology must be at least as\neffective as established technology for the given indication.<\/li><li>Published peer-reviewed literature must\ndemonstrate evidence that the technology improves health outcomes over time for\nthe given indication.<\/li><li>The outcomes for the given indication must be\nobtainable outside investigational settings within the medical community.<\/li><\/ol>\n\n\n\n<p>***<\/p>\n\n\n\n<p><strong>United\nHealthcare\/Oxford Health Experimental \/ Investigational Policy<\/strong><\/p>\n\n\n\n<p>This is for <em>Medicare\ncoverage of clinical trials<\/em>; Policy Date: 1\/1\/2018<\/p>\n\n\n\n<p>Remember that federal or state mandates trump carrier\npolicies. Individual plans vary. Oxford has plans in different states.<\/p>\n\n\n\n<p>Oxford recognizes that <strong>peer-reviewed<\/strong>\ndocuments in scientific and medical literature may establish that an\nexperimental and\/or investigational treatment or procedure <strong>may be better than<\/strong> the standard treatments available to treat a\nmember\u2019s life threatening or disabling condition and\/or disease. [Way this\nreads is more lenient than others; more leeway to appeal and argue your case &#8211;\nJeff].<\/p>\n\n\n\n<p>Oxford has determined that it will create a limited\nexception to the exclusion of experimental and investigational treatments and\nprovide coverage for in-network experimental and investigational procedures\nthat meet the criteria set forth in this policy. Such coverage is subject to\nthe member\u2019s other benefits and exclusions. Oxford\u2019s determination of whether\nthe criteria have been met will be based upon the opinion of an independent\nconsultant\/peer reviewer with expertise in the area of practice appropriate to\ntreat the member\u2019s condition or disease.<\/p>\n\n\n\n<p>Exception: For New York Plans, the member&#8217;s condition and\/or\ndisease is not required to be life threatening or disabling.<\/p>\n\n\n\n<p>United Healthcare\/Oxford Health Under no circumstances will\nthis policy extend coverage to <strong>unproven\ntherapies<\/strong>. [United Healthcare is the only carrier I\u2019ve found so far that\nprovides a separate definition of \u201cunproven.\u201d &#8211; Jeff]<\/p>\n\n\n\n<p><strong>Unproven therapies<\/strong> are treatments or procedures that lack\nsignificant medical documentation to support their medical effectiveness.\nOxford does not provide coverage for any treatment modality that has not been\nproven medically effective or is not generally recognized as effective or\nappropriate for the particular diagnosis or treatment of the member\u2019s\nparticular condition.<\/p>\n\n\n\n<p>Documentation Requirements: The member\u2019s <strong>medical record<\/strong>, in conjunction with at\nleast <strong>two (2) published peer-reviewed\ndocuments<\/strong> from the available scientific and medical evidence and any other\npertinent information supplied, must establish that the proposed experimental\nor investigational treatment is likely to be more beneficial that any standard\ntreatment(s) for the member\u2019s life-threatening or disabling condition or\ndisease.*<\/p>\n\n\n\n<p>The UH policy is long and very detailed; recommend reading\nfor the ambitious.<\/p>\n\n\n\n<p>***<\/p>\n\n\n\n<p><strong>Ventura County Health\nPlan Experimental \/ Investigational<\/strong> Policy Date: 2\/14\/2019<\/p>\n\n\n\n<p>Approval for E\/I\/U procedures must be consistent with\n\u00a71370.4 of the Knox Keene Act, experimental or investigational procedures:<\/p>\n\n\n\n<p>Life-threatening condition;\nstandard treatment unsuccessful, ineffective and proposed treatment likely to\nbe effective; treatment is &#8220;promising.&#8221;<\/p>\n\n\n\n<p>A <strong>promising treatment<\/strong>\nis one that has shown effectiveness as supported in credible peer reviewed\nliterature or by the credible medical opinion of independent medical experts in\nthe relevant specialty, designated by VCHCP. [First instance of \u201cpromising\ntreatment\u201d defined &#8211; Jeff]<\/p>\n\n\n\n<p>This policy outlines how to get an <strong>E\/I\/U treatment approved<\/strong>; it is not how to avoid the designation,\nit is how to <strong>get an exception<\/strong> to a\nprocedure that is listed as not covered..<\/p>\n\n\n\n<p>***<\/p>\n\n\n\n<p><strong>Wellmark BC-BS<\/strong> is\nin Iowa and South Dakota. It is dominant in Iowa. It is an independent\nlicensee.<\/p>\n\n\n\n<p>The terms &#8220;unproven, experimental or\ninvestigational&#8221; are generically defined as: A supply, procedure, therapy\nor device whose <strong>effectiveness has not\nbeen demonstrated<\/strong> by required scientific evidence and properly authorized\nby governing entities in order to be acknowledged as medically effective for\nthe improvement of function for specific conditions or treatment. Policy Date: 2\/6\/2020<\/p>\n\n\n\n<p>A treatment is considered investigational or experimental\nwhen it has progressed to limited human application, but has not <strong>achieved recognition<\/strong> as being <strong>proven effective<\/strong> in clinical medicine. 2\/6\/2020<\/p>\n\n\n\n<p>To determine investigational or experimental status, we may\nrefer to the technical criteria established by the Blue Cross and Blue Shield\nAssociation, including whether a service, supply, device, or drug meets these\ncriteria:<\/p>\n\n\n\n<p>It has final approval from the appropriate governmental\nregulatory bodies. FDA approved<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>The scientific evidence must permit conclusions\nconcerning its effect on health outcomes. conclusions are overwhelming and\nconsistent<\/li><li>It improves the net health outcome. focus on net\nhealth outcomes<\/li><li>It\u2019s as beneficial as any established\nalternatives. no other alternatives<\/li><li>The health improvement is attainable outside the\ninvestigational setting. outside setting<\/li><\/ol>\n\n\n\n<p><strong>General E\/I\/U Information<\/strong><\/p>\n\n\n\n<p>The national Blue Cross and Blue Shield Association has a\nMedical Advisory Panel responsible for setting policy on what is Experimental \/\nInvestigational \/ Unproven.<\/p>\n\n\n\n<p>State boards also weigh in on what is considered experimental,\ninvestigational, unproven or allowed. A good example from Eyecare is that\noptometrists are specific set of procedures but it varies by state Optometry\nboard.<\/p>\n\n\n\n<p>Use <strong>quantitative\nscores<\/strong> whenever possible (e.g., decrease of pain, increase of mobility, six\nminute walk evaluation, risk of fall).<\/p>\n\n\n\n<p>Some carriers define <strong>defect\n<\/strong>as: pain or other physical deficit that interferes with activities of daily\nliving or impaired physical activity.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Keyword \/ Verbiage List<\/h2>\n\n\n\n<p><strong>General Notes<\/strong><\/p>\n\n\n\n<p>Avoid &#8220;enhance aesthetics&#8221; or any verbiage considered\ncosmetic; confirm this with all your Providers and their office visit\ndocumentation.<\/p>\n\n\n\n<p>Always include at least<strong>\ntwo documents<\/strong> of medical and scientific evidence [to support claim] (two\npolicies indicated two)<\/p>\n\n\n\n<p>\u201cexcluded\u2026are procedures\u2026that have not successfully\ncompleted a phase III trial\u201c [Molina healthcare].<\/p>\n\n\n\n<p>One policy specifically referenced \u201cUnited States research\u201d\nwhich would omit a lot of foreign research on liposuction and lipedema.<\/p>\n\n\n\n<p><strong>Unproven therapies<\/strong>\nare treatments or procedures that lack significant medical documentation to\nsupport their medical effectiveness<\/p>\n\n\n\n<p>Concerning getting an exemption to an E\/I policy denial, often\nif the condition or disease is <strong>life\nthreatening or disabling<\/strong> then the patient can appeal on that basis.\nPolicies vary on this and there may be state regulations concerning\nlife-threatening exemptions.<\/p>\n\n\n\n<p>I\/E are treatments that are currently the subject of active\nand credible evaluation (e.g., clinical trials or research) to determine:\nclinical efficacy, therapeutic value or beneficial effects on health outcomes\n[Healthnet &#8211; I consider this a rather strict interpretation]<\/p>\n\n\n\n<p>Considered I\/E&#8230;treatment progressed to limited human\napplication, but has not achieved recognition as being proven effective in\nclinical medicine. [Wellmark]<\/p>\n\n\n\n<p><strong>Use quantitative\nscores<\/strong> whenever possible (e.g., decrease of pain, increase of mobility, six\nminute walk evaluation, risk of fall).<\/p>\n\n\n\n<p>Some carriers define <strong>defect\n<\/strong>as: pain or other physical deficit that interferes with activities of daily\nliving or impaired physical activity.<\/p>\n\n\n\n<p>***<\/p>\n\n\n\n<p><strong>Include the following\nterms, phrasing and supporting research<\/strong> in your pre-authorization or appeal\ndocumentation package (cut-and-paste):<\/p>\n\n\n\n<p>Medically effective<\/p>\n\n\n\n<p>FDA approval of equipment<\/p>\n\n\n\n<p>Conclusions&#8230;the effect of the intervention on health\noutcomes<\/p>\n\n\n\n<p>Make argument \u2026that measurement(s) or alteration affects\nhealth outcomes<\/p>\n\n\n\n<p>Safe or effective<\/p>\n\n\n\n<p>Exceeding the outcome of alternative therapies<\/p>\n\n\n\n<p>Improve health outcomes<\/p>\n\n\n\n<p>Applicable outside the research setting<\/p>\n\n\n\n<p>The specific diagnosis of lipedema warrants approval.<\/p>\n\n\n\n<p>Well-designed research<\/p>\n\n\n\n<p>Well-conducted investigations<\/p>\n\n\n\n<p>Nationally-recognized medical journals<\/p>\n\n\n\n<p>Published in peer-reviewed journals<\/p>\n\n\n\n<p>Quality of the body of studies and the consistency of the\nresults<\/p>\n\n\n\n<p>Superior clinical outcomes [Fallon health; use of\n&#8220;superior&#8221;]<\/p>\n\n\n\n<p>Greater safety or efficacy than conventional treatments<\/p>\n\n\n\n<p>Technological assessments<\/p>\n\n\n\n<p>Randomized control studies<\/p>\n\n\n\n<p>Published peer literature<\/p>\n\n\n\n<p>Expert opinions<\/p>\n\n\n\n<p>Recognized by the plan as standard medical care for the\ndisease being treated<\/p>\n\n\n\n<p>Peer-reviewed literature<\/p>\n\n\n\n<p>Proven beneficial impact<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Below I reviewed ten Experimental\/Investigational (E\/I\/U) healthcare policies. The goal here is to compare and contrast them. While very similar, there are differences in the definitions, requirements, and restrictions. I have emphasized issues and terms I consider important. Remember my mottos: Words matter Specificity matters Dates matter Accuracy matters Tailoring&#8230; <a class=\"continue-reading-link\" href=\"https:\/\/12uh.com\/lipoforlipedemareimbursement\/experimental-investigational-unproven-treatment-policy-review\/\"> Continue reading <span class=\"meta-nav\">&rarr; <\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[33],"tags":[66,65,40,64,72,56,38,12,171,13,68,70,172,5,6,20,21,24,16,23,52,69,71,59,34,22,26,63,27,67],"class_list":["post-107","post","type-post","status-publish","format-standard","hentry","category-reimbursement","tag-allways-health","tag-anthem","tag-blue-cross-blue-shield","tag-blue-cross-blue-shield-of-north-dakota","tag-blue-cross-blue-shield-of-vermont","tag-claim-appeals","tag-claim-denial","tag-cosmetic-surgery","tag-e-i-u","tag-experimental-investigative-or-unproven","tag-fallon-health","tag-healthnet","tag-i-e-u","tag-lipedema","tag-liposuction","tag-lymph-sparing","tag-medical-claim-form","tag-medical-insurance-companies","tag-medical-necessity","tag-medical-reimbursement","tag-medicare","tag-meridian-health","tag-molina-health","tag-nc00009","tag-pre-authorization","tag-reconstructive-surgery","tag-reimbursement-policy","tag-reseach-studies","tag-tumescent-liposuction","tag-well-blue-cross-blue-shield"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/posts\/107","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/comments?post=107"}],"version-history":[{"count":3,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/posts\/107\/revisions"}],"predecessor-version":[{"id":311,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/posts\/107\/revisions\/311"}],"wp:attachment":[{"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/media?parent=107"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/categories?post=107"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/tags?post=107"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}