Insurance Approval

Does Insurance Cover Weight Loss Surgery?

The answer is "yes"! In most cases, if it is medically appropriate, insurance will cover your weight loss surgery.

Once you have your insurance approval, we are clear to move forward with surgery. If your insurance denies the preauthorization, you have several options available. The first step would be to appeal the denial. If this is unsuccessful, you may request an outside reviewer to examine your request. Finally, there are some legal firms that specialize in helping overweight individuals get approval for surgery. As a last resort, some patients have switched their insurance to a different company. Luckily, these more drastic measure are rarely needed.



How Does the Process Work?
When you call to make an appointment, our insurance specialist will ask for your insurance information -- you can usually find this on your insurance card. After your consultation, the surgeon will compose a "Letter of Necessity" to your insurance company, stating all the reasons why your operation is medically necessary. When all your preoperative testing is done, the letter will be submitted to your insurance company along with all the preoperative information. This process is called "preauthorization" and is required for all elective surgery procedures. Every insurance company takes a different amount of time to preauthorize surgery -- some a few days, others a few weeks, and some a few months.


What Happens When the Preauthorization is Complete?
Once you have your insurance approval, we are clear to move forward with surgery. Our nurse practitioner or medical assistant will schedule your operation for you at a convenient time.

FAQ

Q. What happens if the insurance company decides not to authorize my surgery?

A. If your insurance denies the preauthorization, you have several options available. The first step would be to appeal the denial. If this is unsuccessful, you may request an outside reviewer to examine your request. Finally, there are some legal firms that specialize in helping overweight individuals get approval for surgery. As a last resort, some patients have switched their insurance to a different company. Luckily, these more drastic measure are rarely needed.


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