Insurance and Payment Options
The Bariatric Surgery Center in High Point, North Carolina recognizes that paying for surgery and navigating the world of insurance is difficult for many patients. We are here to help. Our insurance coordinator has a great deal of expertise working with many insurance carriers and we are committed to assisting you through the approval process.
Our office participates with several insurance plans. However, insurance coverage for morbid obesity surgery varies according to the insurance carrier, and those that cover bariatric surgery often limit their coverage to certain types of surgery. If you plan to go through your health insurance for coverage of surgery, we will verify your benefits for surgery and then communicate to you both your benefits and the specific criteria that must be met for your insurance plan to cover surgery.
Insurance companies that cover morbid obesity surgery have varying requirements. Some may require medical records documenting co-morbidities (medical problems caused by your obesity) and/or records of medically supervised weight-loss programs. Many companies require at least six months of participation in a supervised weight-loss program within two years of your proposed surgery date.
The Appeals Process
Even if your initial request for pre-authorization is not approved, you still have options available. Insurers provide an appeal process that allows you to address each specific reason they have given for denying your request. It is important that you reply quickly.
It is also recommended that, at this point, you enlist the help of an experienced insurance attorney or insurance advocate to properly navigate the complexities of the appeal process. Some insurers place limits on the number of appeals you may make, so it is important to be well prepared and that you clearly understand the appeal rules of your specific plan.
If your appeal for insurance coverage is denied, or if you don’t have insurance, there may still be other financial options available to you. We can discuss self-payment options with you to help you pay for your procedure.