Once you have decided to pursue weight loss surgery, we will help you determine whether your insurance company covers the procedure and if there will be out-of-pocket costs for your bariatric surgery procedure.
Below are some of the key steps in obtaining insurance coverage for weight loss surgery:
- Read and understand the "certificate of coverage" that your insurance company is required by law to give you. If you do not have one, consult your company's benefits administrator or ask your insurance company directly.
- Start with your primary care physician. A referral letter and office notes can be submitted to your insurance company. Be sure to bring these records to your appointment.
- Before visiting our bariatric surgeon, organize your medical records, including your history of dieting efforts. They will be valuable documents to have at every stage of the approval process.
- Document every visit you make to a healthcare professional for obesity-related issues or visits to supervised weight loss programs. Document "other" weight loss attempts made through diet centers and fitness club memberships. Keep good records, including receipts.
- If our surgeon recommends weight loss surgery, he will prepare a letter to obtain pre-authorization from your insurance company. The goal of this letter is to establish the "medical necessity" of weight loss surgery and gain approval for the procedure.
Thirty days is the standard time for an insurance provider to respond to your request. You should initiate a follow-up if you have not heard from your insurance company in that time. Our office staff will follow up with your insurance company, but you are encouraged to follow up as well.