LET US HELP YOU, HELP YOURSELF: OBTAINING COVERAGE FROM YOUR INSURANCE COMPANY
Once considered purely elective surgery for people who were simply unwilling to “try” to lose weight on their own, insurance companies are slowly beginning to recognize that obesity is a progressive disease for which surgery is a truly viable medical solution. They are also beginning to understand that covering metabolic and bariatric surgery now will, in fact, save them money in the long run, as the long-term costs of obesity-related health problems far outweigh the short-term cost of resolving those issues through surgery. Yet despite their increasing willingness to recognize these facts, they don’t make the process easy, and understanding what your insurance requires for approval and navigating through the seemingly endless paperwork on your own can seem just as impossible as fighting obesity on your own.
At The Center for Metabolic and Obesity Surgery, in Altamonte Springs, Florida, we believe that the difficult job of navigating through the complexity of the insurance approval process should not hold you back from pursuing life-changing metabolic or bariatric surgery. Our helpful, experienced office staff will work closely with you and your insurance company throughout the entire approval process, providing access to specialists whose evaluation may be required, helping you complete the necessary paperwork to gain needed referrals and recommendations, and keeping your insurance company informed about the importance of this surgery to your long-term health and well-being. Dealing with insurance to get the coverage you deserve can be difficult, but by working together with us, it need not be impossible!
THE INSURANCE APPROVAL PROCESS
Each insurance company has its own set of criteria and requirements to determine what they will cover and at what rate, so the first step is to take a detailed look at your company’s specific requirements. We can help you read the fine print to understand exactly what your insurance company covers, as well as their criteria for determining eligibility. As you continue to slog through the details, it can be easy to get discouraged, but don’t give up: if your surgery is medically necessary, it may be possible to obtain coverage even if it seems, at first glance, that you do not meet all their criteria. Once you have read and understood the fine print, we will work with you to pull together the required paperwork. Some of the most common paperwork requirements include (but are not limited to):
Medical records: Comprehensive medical records from your primary care physician, as well as clearances from various specialists, are usually the first item on the approval paperwork checklist.
Medical evaluations: Our practice incorporates both a Board Certified psychiatrist and a certified nutritionist to work closely with Dr. Beltre and yourself to expedite the insurance approval process.
Documentation of prior weight loss attempts: Appropriate documentation may include medical charts showing “medically supervised” weight loss attempts, as well as documentation showing “professionally supervised” weight loss attempts through Weight Watchers or Jenny Craig, for example.
Letter of necessity: Although details vary by company, most letters of necessity will need to include current weight, height, body mass index, the medical problems related to obesity, your past weight loss attempts, and why the physician believes it is medically necessary for you to have bariatric surgery.
The first step to the approval process is determining whether your insurance carrier offers complete or partial coverage of metabolic and bariatric procedures. We can help! Simply provide us with some information about yourself and your health insurance carrier, and we will contact your provider to find out exactly what procedures they will cover and other details of their coverage policy. Then, we can begin working with you to gain the necessary approvals and clearances in order to move forward with your chosen surgical procedure.
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CONTACT THE CENTER FOR METABOLIC AND OBESITY SURGERY
At The Center for Metabolic and Obesity Surgery, located in Altamonte Springs, Florida, we offer a proven, multifaceted approach to metabolic and bariatric surgery that will empower you to achieve your weight loss goals, improve your health and appearance, and rebuild your self-confidence. Led by esteemed, Board Certified surgeon Dr. Wiljon Beltre, one of the only fellowship-trained bariatric surgeons in Central Florida, we specialize in the latest cutting-edge procedures for safe, effective surgical weight loss coupled with a dedicated support team of caring, experienced specialists who will stand by your side to support you throughout your entire weight loss journey. Significant weight loss is not easy, but with the help of with our confidential consultation and education process, the surgical skill and experience of our medical team, and the advice and guidance of our ongoing support network, we can help you achieve the lasting weight loss success you have been dreaming about.
If you are tired of the endless rounds of fad dieting and fruitless exercise regimens and think you may be ready for significant weight loss with metabolic or bariatric surgery, and you would like us to help you work with your health insurance carrier to obtain coverage for your procedure, contact The Center for Metabolic and Obesity Surgery today for a free consultation. We look forward to helping you start your weight loss journey! Call 407-634-4375 or Click Here to Schedule a Consultation.