Weight-Loss Surgery Process

As you may already be aware, seminars are held several times a month at our Meadow Lane location. Get seminar schedule information >

This step pertains only to insurance patients. Following the seminar, the next step is to contact your insurance company and inquire about your bariatric benefits. Many employers opt to pay a lower level of coverage that excludes weight-loss surgery so there is a possibility that you will have a “specific exclusion” for weight-loss surgery. If there is no exclusion in your policy, then it may be a covered benefit for you. Many insurance companies require additional testing or information (for example: referral to our program, medically supervised diet(s), weight history supported by progress notes documented by a physician, and / or nutritional counseling). Please be aware that coverage often changes without any notice to members or providers.

We will contact you to discuss your next step in our program and answer any questions you have. Depending on your specific situation, we will explain the details of your insurance coverage or our cash-pay plan if your insurance carrier does not cover the cost of the surgery. You will also be informed of your insurance company’s specific requirements to pre-approve weight-loss surgery (if applicable).

This step only applies to some patients. Some insurance companies (HPN, Tricare, Senior Dimensions, PacifiCare, etc.) require a referral to our program. This must be obtained before proceeding onto other steps.

Prior to meeting with the surgeon, every patient must first complete the insurance pre-surgery requirements which can include a three to six month diet, psychological evaluation and a series of medical testings. If your insurance requires some form of a supervised diet in order to get approval, do not begin the testing process until your diet has been completed, sent to our office for review and approved by us. Your testing may expire if done prior.

It is very important that you submit the most detailed and documented diet history that you can provide. Most insurance companies require patients to show documentation of all weight-loss attempts with diet programs or other physicians.

Documentation can be in the form of copies of office visits where weight-loss programs were discussed, or other documentation that your primary doctor may have. Proving that you participated in a medically-supervised weight-loss program will help facilitate your approval with the insurance providers. A lack of documented weight-loss attempts are the number one reason for insurance denial.

No matter what your situation, we are here to help you through this process of completing the necessary testing and are available to answer any of your questions. Every test can be performed at the outside facility of your choice.

Once the ordering physician has received the results, you can:

1. Pick up the results and personally deliver them to our office
2. Have your primary care doctor fax all of the results to us
3. You can scan and email the results to your patient advocate

The results must be submitted to our office.

As results arrive at our office, they will be added to your file. Once all standard tests and clearances have been collected the file will be reviewed by a Nurse Practitioner or the Physician Assistant. You will be contacted if your results require further discussion or further testing. Once the review is completed we will contact you to schedule your consultation appointment with the medical provider.

Required for all patients

All patients are required to complete a psychological exam, Blood Test, Chest X-ray, EKG, and a medical clearance letter. The blood work, EKG, and Chest X-Ray must be done through your Primary Care Physician. Once they’re completed, it is your responsibility to contact your patient advocate to let them know that all the tests are finished. We only need a report on the x-ray. Please don’t send the films.

Additional testing or clearances that may be required

Additional testing and clearances may be required by your insurance provider or by our physician if any of your preliminary test results suggest that additional testing is necessary.