Preparing for Weight-Loss Surgery Insurance/Cost
> The Role of a Patient Advocate
> Will my insurance pay for my surgery?
> What insurances does Texas Bariatric Specialists accept?
> Further Information
Insurance coverage and the cost of weight-loss surgery are perhaps one of the greatest concerns for patients who consider weight-loss surgery. The questions of patients often ask are “will my insurance cover it and if not, how much is this procedure going to cost?” Texas Bariatric Specialists have a long standing firm belief that first and foremost a patient should consider the benefits of surgery and hopefully identify a procedure which will best serve them prior to even worrying about insurance and cost. Mental and physical preparation for surgery should be your first and foremost consideration when evaluating surgical options. With that being said money and financing cannot be overlooked. Through our “all-in-one” approach, Texas Bariatric Specialists significantly streamlines this entire process into one long but productive day.
- Upon registering for your new patient seminar/clinic you will be asked for your insurance information.
- At your one-on-one consultation with Dr. Patel he will review whether or not you have the benefit of weight-loss surgery what your benefit plan requires you to do to prove medical necessity and what your out-of-pocket expense will be if you pursue surgery. Very few if any surgeons take the time to review this valuable information with you and the end of the consultation he even gives a “projected surgery day/month”
- Dealing with an exclusion (weight-loss surgery not covered by your insurance)
- Many patients consider visiting the surgeon a total waste of time if they have an exclusion or when surgery is not an option. Nothing is further from the truth, if one considers the value of visiting with a weight-loss surgeon who offers medical and surgical weight-loss and for evaluations by a nutritionist who and can improve your behavior related to eating and potentially have you lose a modest amount of weight. The benefits should not be under spoken. There are other options out there other than weight-loss surgery including medical weight-loss. Additionally things in the insurance environment and with your employer’s policies change constantly and Dr. Patel can help advise you of what changes one needs to look for, and other changes that you may be able to make in regards to coverage. One should never consider it a waste of time to visit with the surgeon and to be initiated into a program for your overall well-being even if the insurance company says no.
- You will then be assigned a unique username and password which will allow you to access our database online from any computer in the world to evaluate where you are and insurance authorization process. This is unique to any program in South Texas, where you can have a moment-by-moment update in regards to your progress through a tedious insurance verification process and authorization process. Through this matrix, the computer will demonstrate what tests that are still pending what tests that have been completed and the number of months remaining in your pre-previous predetermined weight loss program
- Once you have met with Dr. Patel you will be assigned to an insurance advocate. The assignment of advocate is based upon your insurance and the timeline within which you are going to be able to achieve surgery and where you are going to pursue your physician supervised by a program.
- Physician Supervised Diet Programs- Many insurance programs can require a three to 12 month weight-loss process prior to surgery. As part of this process a member of our staff will contact each patient at least once a month personally or via the e-mail.
- If based on the discussions that you have had with Dr. Patel regarding insurance benefit and your out-of-pocket expenses and a timeline within which your surgery should be able to be approved are not being met by your standards, you are encouraged to e-mail Dr. Patel directly at drpatel@bypassdoc.com. This individualized attention given by Dr. Patel is a hallmark of his practice from the time of its initiation and now even with hundreds of patients in the pipeline. He offers this unique one-on-one level of access and you are highly encouraged to stay in touch with him at any point your case is not being addressed to your satisfaction.
The Insurance process for your weight-loss surgery can be a very stressful process. Our center designates a Patient Advocate to each of our patients. This person will do the following:
- Call your insurance company for you and verify if your company offers the benefit
- Walks you through step-by-step through all the things that the insurance company will require to do if coverage is available
- Assist in financing options (link to financing) if insurance coverage is not available
Will my insurance pay for my surgery?
Many insurers in fact will cover your weight-loss surgery but it is difficult to achieve insurance authorization on your own. This is why we assign each patient a personal authorization specialist to stream-line this process. Insurance coverage varies from patient to patient and employer to employer. This is why its important to work with a specialist.
What insurances does Texas Bariatric Specialists accept?
We accept all priivate insurances. Both in- and out-of-network insurance plans are accepted. Please call us for details as all “in-network” provider lists are not always complete or up to date.