Am I a candidate?
The following are the usual criteria that must be met by a patient to be accepted as a candidate for surgery:
- at least 100 pounds above the ideal weight and has a body mass index of greater than 40, or have a BMI greater than 35 with a co-morbidity of diabetes, hypertension, or sleep apnea
- between the ages of 18 and 65 years
- long-standing obesity with a history of documented weight loss attempts
- a commitment to follow-up appointments and compliance with program guidelines
Does insurance cover the procedure?
In most circumstances, the answer is yes. Many insurance companies are willing to pay for obesity surgery if a case can be made for medical necessity. If you meet the medical criteria established by the American Society for Bariatric Surgery and the National Institute of Health, our staff will present the necessary information to the insurance company and request pre-authorization. Medically appropriate patients usually have their cases approved and paid for by insurance unless there is a specific exclusion in your policy.
Some insurance companies require a detailed diet history. A letter from your primary care physician documenting your weight loss efforts would be needed. This letter must show that you have participated in at least one medically supervised weight loss program which lasted at least six months, along with monthly weigh-ins.
Your primary care physician's office notes must clearly document this weight loss program.
IF YOU ARE INTERESTED IN THE LAP-BAND, PLEASE NOTE:
- Lap-Band adjustments may not be covered by your insurance plan.
- The 1st adjustment is covered within the post-op period.
- Each additional adjustment is $125.00.
Attend an Information Session - The surgeon will discuss in detail the weight loss procedures that we offer. This discussion will include the risks and benefits of each procedure and give you the opportunity to ask any questions you may have. You will also meet some members of our team.
Click here for the Information Session Schedule
Submit an application - All potential patients are required to submit an application. Upon review of your application you will be scheduled for an education session.
Education Session - During the education session you will meet with our nurse practitioner, nutritionist, pre-surgical coordinator and insurance coordinator to discuss how to proceed towards surgery. You will be given a list of evaluations/clearances that are required prior to surgery.
Nutrition Evaluation - This is to go over what to expect in terms of diet and food texture changes immediately after surgery.
Surgical Consultation - You will meet with the surgeon and undergo a history and physical exam. We will discuss the surgery that you are interested in.
Completion of evaluations/clearances - These are evaluations that are required prior to surgery to ensure that that you can undergo your surgery safely.
Schedule surgery- upon completion of all evaluations and insurance approval, we will be able to schedule your surgery.