Insurance Verification

Detail in Verification
Verifying benefits for weight loss surgery can be very time consuming and detail intensive. While the medical guidelines for qualification seem straight forward enough, often , the additional personal historical information is often overwhelming. We can help you negotiate the pitfalls of the managed care landscape.

Some have argued that the verification challenges imposed on those seeking obesity surgery constitutes discrimination, and advocacy groups have been working for years on simplifying the verification process. Still, the need for consistency, thoroughness, accuracy and determination when seeking insurance verification can be daunting to the uninitiated.

Patient Information Form
If you are interested in investigating obesity surgery as an option for weight loss, please take the time initially to fill out our Patient Information Form. His will allow us to implement the necessary preliminary investigative process to see if you are potentially covered for any surgical weight loss procedure as well as outline your medical candidacy. The form takes only a few minutes but is extremely valuable in helping us expedite the process and be as helpful to you as possible.

It is not uncommon for a policyholder to contact his or her insurance company and to be told that all medically necessary treatments are covered by their insurance, but there may in fact be exclusions or additional requirements to some surgical procedures once you dig a bit deeper into the policy terms.

Our office staff know the questions to ask so please do permit us an early opportunity to verify your coverage. This also allows us to make certain that we help you to gather all necessary additional information your insurance company may require in order to get you approved as quickly as possible.

There may be some additional medical testing, or some additional processes that you will need to complete prior to being approved. Some of these may include physician-supervised diets and will require several months of documentation.

We will contact you within 3 business days of receiving your information to let you know if you are potentially covered, and to implement a strategic plan for achieving approval if there are additional requirements that your insurance provider has.

In the Meantime, You can Help
Once we have contacted you and arrange for an appointment, we will likely require up to 5 years of medical history from you, your primary care physician(s) and specialist(s) to help compose a scenario of past medical weight-related conditions, diet attempts, history of obesity etc.

Any unofficial history that you have recorded may be of assistance in establishing a strategy for insurance approval as well, so leave no stone unturned. Your own documentation may also be a valuable tool in establishing your past attempts at weight loss, and your victories and failures in order to best apply a post-surgical strategy for achieving your long term goals.