Bariatric surgery cost vary depending on the type of surgery that the patient will undergo but normally the cost is quite affordable for those people who have health insurance plan.
Those people who don’t have their health insurance can still avail the procedure through self-pay or cash pay. Whether you have health insurance or you will have it self-pay, you still need to arrange detailed documents containing important information from your diet history up to morbid obesity conditions you have.
The documentation will be part of your evaluation process to know if you qualified for the bariatric surgery.
Insurance and Bariatric Surgery
Many states in the United States have already passed legislation stating that insurance companies should provide benefits for patients of the weight loss surgery that had met the criteria of National Institutes of Health.
However, insurance companies require lengthy and oftentimes complicated process. Being approved for the insurance coverage may not be easy but this is possible if you work closely with your bariatric surgeon.
Here are some steps, which you have to take in order to be approved for insurance benefits for your weight loss surgery:
Read and review the certificate of coverage of your insurance policy. If you don’t have the copy, consult your insurance company or call the insurance directly.
Oftentimes, you will be required to visit first a primary physician. When you visit the primary physician, you may ask a referral for a bariatric surgeon. It is even better if your primary physician can also cooperate with your bariatric surgeon in order to follow through with your health condition.
Before you visit the recommended bariatric surgeon, you have to organize first all your medical records, which may include the diet plans that you have tried before.
You may also include in the documents other weight loss programs that you have tried to including diet centers and gym classes that you have tried.
If you pass the evaluation of the bariatric surgeon, the surgeon will then create a letter for a pre-authorization to your insurance company. The main aim of the pre-authorization letter is to establish the “medical need” of the weight loss surgery.
The common information needed in the pre-authorization letter may include:
Weight, height and body mass index
Complete description of your morbid obesity including the health related problems that results from your morbid obesity. To support this, you have to include all the medical history, types of medications and the effects of these conditions to your life.
Detailed description of the things that you as morbid obese person had delimited your daily activities.
Complete history of all the dieting efforts that you have done and this should include all the medical diet programs, medical records and even receipts of all the weight loss programs that you have attended.
Include the pre-authorization letter all the tabs and receipts of payment for all health clubs that you have attended.
You may ask your doctor to give documentations that will completely state all the positive results of weight loss surgeries.
The normal process for the approval of the insurance takes around thirty days. You have to initiate to make a follow up if you have not received any answer from them.
If you were rejected by the insurance company, you can still appeal the decision. However, it is important that you answer clearly the reasons why you were denied. It is also recommended that you pass your appeal quickly.
For positive results, you may ask the assistance of insurance advocate in order to guide you regarding the rules of appeal process.
