Insurance
Insurance plans vary on the coverage they
provide for bariatric surgery. It is important
for a patient to become an informed consumer.
If health benefits are provided through your
employer, prior to making an appointment, contact
your employee benefits office and confirm that
treatment of obesity with weight-reduction
gastric surgery procedures are covered by the
plan and that this surgery has not been excluded
from the benefit package.
Dealing with insurance approval can be a
frustrating step in the pre-surgery process.
Approval can take a week or several months.
The Bariatric Surgery program is very experienced
with the insurance approval process and will
do everything possible to ensure that the process
is expedited as efficiently as possible.
The authorization process will be initiated
upon completion of any identified pre-requisites.
To assist in making this process proceed as
smoothly as possible, please obtain the following
before your initial surgical appointment:
- If required by your insurance provider,
a written copy of the insurance referral
from your primary physician.
- A copy, front
and back, of your insurance card.
It is important to remember that insurance
providers may pre-approve the surgery yet not authorize it.
Pre-approval means the insurance company will
cover the surgery if they determine that it
is a medical necessity. It does not guarantee
final authorization. The insurance approval
process is the responsibility of the surgeon's
office.
If the insurance company denies authorization
for surgery, then the patient has the right
to appeal. Some patients have successfully
reversed insurance denials. This can be a complicated
and lengthy process, but rewarding.
While waiting for the insurance authorization,
utilize this time by attending support group
meetings, talking with other pre and post-op
bariatric patients, and begin an exercise program.
Also, begin to change your diet by incorporating
the recommended dietary practices that will aid
in preoperative weight loss and promote long-term
success. This is valuable time that can be used
to develop a healthier lifestyle.
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