Weight Loss Getting Started

How To Get Started

The process leading up to bariatric surgery varies depending on each person’s medical history and insurance requirements.  You may qualify for our new Fast Track Program! It contains ALL of the high-quality pre-surgical preparation we are known for, simply redesigned to help qualified patients get to surgery in HALF the time!

 

First, please complete our online seminar. Access the Online Seminar here, enter your contact information and complete the online seminar quiz.

 

 

Once insurance review is complete a member of our staff will contact you to set up an appointment for an evaluation.  When you attend a seminar at our facility, you will have the opportunity to speak with any number of our Bariatric Staff, including our Surgeon, Dr. Eric Smith; Heather Pile PAC Dietitian, Cindy Jester Caywood, MS, RD, LD; and Insurance Coordinator, Jennifer Morris.

 

Or, you can call us at (502) 570-3727 to schedule a live seminar.

 

Remember, we can’t officially start your process until we get your paperwork, so register for a seminar or call us at(502) 570-3727 to get more information.

Seminar Calendar

  • April 23, 2018 @5:30pm
  • May 21, 2018 @5:30pm
  • June 18, 2018 @5:30pm
  • July 16, 2018 @5:30pm
  • August 13, 2018 @5:30pm
  • September 10, 2018 @5:30pm
  • October 22, 2018 @5:30pm
  • November 19, 2018 @5:30pm
  • December 17, 2018 @5:30pm

Online Seminars

Evaluation Appointment

The evaluation appointment is scheduled for about two weeks after we call you. It’s a group meeting with a nurse, dietitian, surgeon and insurance specialist. You’ll also have a one-on-one meeting with the physician assistant for an initial history and physical.

 

After that visit, you will be scheduled for:

  • A nutrition assessment.
  • A psychological evaluation.
  • A weight management program (if your health insurance requires this).
  • Additional medical tests, as determined by the surgeon.
  • You will need to attend a support group. People who have undergone bariatric surgery find it easier to make the necessary lifestyle adjustments when they have the opportunity to meet and talk with other people going through the same experience.
  • Your medical record will be reviewed. After all your tests are completed you will learn whether the clinic’s surgeon/physician assistant has cleared you for surgery.
  • Your case is sent to your insurance carrier for approval.
  • After the insurance company approves the surgery, your pre-operative appointments and surgery will be scheduled.

Insurance & Financing

By using the Insurance Review Form in the Patient Profile Packet, you will know if your policy has benefits for weight loss surgery. If it does and you want to proceed, send in your Patient Profile Packet and the Insurance Review Form. We will screen your health history to make sure you are an appropriate candidate and our Insurance Team will make sure you meet the criteria set forth by your insurance policy. Assuming you meet all criteria, we will call to schedule your first appointment, where you will receive a personalized benefits form that will estimate, to the best of our abilities, your total out-of-pocket expenses.

 

You will also need to complete a seminar, either in-person at our facility, or online. Click here for our on-site schedule, or here to begin our online seminar.

Insurance FAQs

Most insurance plans require that your BMI be 40 or higher. However, if your BMI is between 35 – 39.9, we can sometimes get you approved if you have a life-threatening medical condition, such as high blood pressure, diabetes or sleep apnea.

Does my insurance have benefits for weight loss surgery?

  • For commercial insurance policies; Contact the customer service number on the back of your insurance card and ask this question exactly. “In my certificate of coverage are there benefits for weight loss surgery for morbid obesity if medically necessary?”

 

  • For Medicare and Medicaid; there are benefits for weight loss surgery as long as the criteria is met. There is no need to contact Medicare and Medicaid.

If I meet the co-morbid and BMI requirements do I still have to do a diet?

Most insurance companies that require a diet still require the diet no matter how many co-morbid diagnoses you have.

If my doctor writes a letter saying I really need the surgery, do I still have to diet?

YES… the diet is part of criteria set by your insurance company. Your physician can write you a letter of support which will assist in obtaining approval, but you still have to complete the diet.

My Co-Worker/friend started at the same time I did, why is she moving through the process faster than me?

This is a question that is asked a lot… sometimes additional testing is required, one primary care may get the documentation back faster, or if your friend has a different insurance than you, maybe you were required to do a diet and your friend was not. If the insurances are different, then it may be because one insurance just takes longer to process than the other.

My Insurance says I need a medically supervised diet, what does that mean?

Usually the diet must be for at least 6 full months, which is one initial visit and 6 follow-up visits. Your appointments must be consecutive and the diet must be successful, meaning your end weight must be the same or less than your start weight.

What if my insurance says there is an exclusion in my policy?

This means that your particular plan does not have benefits for weight loss surgery, no matter if you meet the medical necessity requirements or not. Your insurance may tell you that you have appeal rights, keep in mind that you will be appealing policy and not medical necessity. If there are no benefits for weight loss surgery it basically means that the benefit was not purchased by your company.

Your question about insurance wasn't addressed?

Give us a call at (502) 570-3727 or register now for our FREE live seminar and take the first step in your weight loss journey.


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*This form is not intended for submission of personal medical information. Results may vary. Specific results are not guaranteed and are a result of the individual customized weight loss plan for each patient, along with exercise, diet, and lifestyle changes.