Will Your Insurance Company Pay for Bariatric Surgery?

“Will my insurance company pay for weight loss surgery?”

This is one of the most common questions we hear from individuals considering a bariatric procedure. If you are thinking about having weight loss surgery in Denton with Dr. David Provost,  we will verify your insurance benefits prior to your complimentary information session.

At the Bariatric Information Seminar, you will meet with Dr. Provost and our financial coordinator. You will be given your specificHealth Insurance mandated insurance criteria, such as a 5 year physician-documented history of obesity, 3-6 months of physician- supervised weight loss, 3-6 months of dietitian-supervised weight loss, psychological evaluation, and any medical clearances. Some insurance companies may require more information.  The sooner you complete the criteria and send it to us, the sooner we can get you to surgery.

If your insurance company will not cover bariatric surgery, our financial coordinator will call you and discuss cash pay options.

If you do not have any criteria to meet, call the office at 940-323-3450  to set up an initial surgical consult.

If you have insurance mandated criteria to meet, be sure you and your primary care physician carefully reads the directions for documentation of the 3-6 months of medically supervised weight loss. To ensure correct documentation, fax your physician’s first office visit note to the insurance coordinator at Dr. Provost’s office. After completion of the second to last month, please call our office to set up an initial surgical consult.

If you have any psychiatric or medical clearances to obtain, please obtain these before your initial surgical consult. Bring these records with you to your first visit or fax this information to our insurance coordinator.

At your initial surgical consult, Dr. Provost will explain the details about weight loss operations, including risks/ benefits and dietary changes that can be expected, as well as answer any questions you may have. Once all documentation is received, we will contact your insurance company to obtain approval. This may take up to 30 days, and appeals may be necessary. Once written approval has been obtained through our office, the bariatric nurse coordinator will contact you regarding scheduling a surgery date. Typically, 2-7 business days prior to your date of surgery, a pre-operative appointment will be necessary.

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