Patient Health Questionnaire:
Our patient health questionnaire is an important tool that assists our team in capturing a bariatric patient’s complete medical history, including a weight/diet history. This form must be completed, signed, and returned to the office before your initial appointment with one of our bariatric surgeons can be scheduled. A copy of your insurance card(s) and/or policy information is also necessary so that we can verify your insurance coverage and any benefits you may have for bariatric surgery.
Once our insurance staff has verified your insurance, we will contact you to discuss your benefits and schedule your appointment. Appointments are available Monday – Thursday afternoons. This appointment begins at our office (5619 Hwy 311) with a brief meeting with our Patient Rep to review policies, fees, and insurance pre-determination requirements. Patients then meet with our bariatric surgeon and nurse at Physicians Medical Center (218 Corporate Drive). The initial appointment typically lasts 3 or more hours.
Insurance & Bariatric Surgery:
Many insurance plans cover bariatric surgery when medical necessity criteria set forth in the medical policy are met. Our insurance specialists will verify whether your insurance plan covers or excludes bariatric surgery.
As a patient, you may also want to verify your coverage. Typically this information can be found in your insurance plan benefit booklet under Covered Charges or Exclusions/Limitations. Look for language regarding coverage or exclusion of the disease obesity or morbid obesity. Your employer’s Human Resource department can also assist you in determining what is covered under your plan.
Insurance criteria for bariatric surgery can vary among plans, but the standard criteria follows:
- Age of surgical candidate between 18 – 65
- BMI greater than 40 or greater than 35 with at least one severe co-morbidity such as diabetes mellitus, hypertension, or obstructive sleep apnea
- Duration of obesity ranges from 1 – 5 years
- Letter of medical necessity & clearance from patient’s primary care or family physician
- Documented attempt of a physician-supervised diet and exercise program (required length of program varies among medical policies)
- Pre-operative psychiatric consultation
- Pre-operative nutritional consultation
Our Patient Rep will work with you to coordinate and collect the information your insurance requires and will submit an insurance pre-determination (request for pre-approval) for bariatric surgery. It can take 30-45 days for some insurance companies to finalize their coverage decision. Surgery can be scheduled after the insurance company reviews the medical information and makes its determination.
What if my insurance doesn’t cover Bariatric Surgery?
Outside financing companies such as Prosper Healthcare Lending, Care Credit and United Medical Credit offer short- and long-term financing programs to qualified patients. Be sure to check with our office to see which programs we currently accept. Many patients seek other financing sources such as bank loans or personal retirement accounts. Personal expenses for bariatric surgery can be tax-deductible under certain conditions.
We are pleased to offer Prosper Healthcare Lending as the premier patient financing company in the healthcare industry. With over $3 Billion borrowed and over 250,000 people empowered, this is a name and a program you can trust.
Here are some of the benefits you’ll receive with a loan from Prosper Healthcare Lending:
- Immediate decisions for loans under $35,000
- Longer terms for lower monthly payments
- No collateral required
- No prepayment penalties
- Fast & easy loan inquiry process
- 100% Confidential
We believe in long-term support of our bariatric patients and hold monthly support group meetings at Physicians Medical Center on the third Wednesday of each month. Patients who have had bariatric surgery with our practice as well as those pursuing bariatric surgery are invited to attend. Click here for dates, times, and meeting topics. Support group attendance is encouraged!
If you have any questions, please contact our staff at (985) 868-2206 during office hours. We are happy to assist you in any way we can.
Thank you for choosing our practice!