Prior Approval Forms

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Aesthetic Surgery

• Prior Approval – Abdominoplasty
• Prior Approval – Blepharoplasty
• Prior Approval Form – Breast-Augmentation-Non-Cancer-Related
• Prior Approval Form – Female Breast Reduction (Asymmetry)
• Prior Approval – Removal of Benign Skin Lesions
• Prior Approval – Surgical Removal of Lipomata

Ophthalmology

• Prior Approval – Minor Eyelid Surgery

Other

• Prior Approval – Anal skin tags
• Prior Approval – Botulinum Toxin for Axillary Hyperhidrosis
• Prior Approval -Ventral Mesh Rectopexy & Stapled Transanal Rectal Resection (STaRR)