Payment Options - Medical Insurance

For patients with medical insurance, Dr. Snow's office will handle all insurance applications. Working with our office is the most effective and efficient process for obtaining approval of your weight loss surgery. We will assist you in preparing a complete, detailed and well documented application to your insurance company. Obtaining insurance approval can be a lengthy process.

Here are some of the key steps you should take to obtain insurance coverage for weight loss surgery:

CALL YOUR INSURANCE
Ask about gastric bypass (weight loss surgery) and if your policy has coverage for this type of service. Some policies will exclude weight loss treatment. Just because your friend, for example, with Blue Cross/Blue Shield was approved, that absolutely does not mean that your policy with Blue Cross/Blue Shield will allow it. EVERY POLICY IS DIFFERENT. Please do this prior to submitting your application!!

VISIT YOUR PRIMARY CARE PHYSICIAN
Request copies of your medical records from physicians who have treated you in the past 5 years. Also, document your history of dieting efforts. All of this documentation is necessary for pre-certification with your insurance. Physicians also should be asked to write a letter of support for this procedure. The documents and your history will be valuable documents to have at every stage of the approval process and are absolutely mandatory to become accepted. Although it is a complicated process, Lone Star Bariatrics will provide its experience and knowledge along the way.

MEET OUR STAFF
If it is determined that you are a candidate for surgery and that you have sufficient documentation, we will do the rest. First, we prepare a letter to obtain pre-authorization from your insurance company. The goal of this letter is to establish the "medical necessity" of weight loss surgery and gain approval for the procedure.

The following information is generally included in the pre-authorization letter and you should bring these things with you to your first office visit.

1. Your height, weight and Body Mass Index and any documentation you might have as to how long you have been overweight.

2. Simply describing your condition as "morbid obesity" is not enough. A full description of all your obesity-related health conditions, including records of treatment, a history of medications taken and documentation of the effects these conditions have had on your everyday life is necessary.

3. A detailed history of the results of your dieting efforts, including medically and non-medically supervised programs, medical records and records kept of payments to and meetings attended with commercial weight loss programs.

4. A history of exercise programs, including receipts for memberships in health clubs.

5. A letter from your general physician(s) stating that you are a candidate for bariatric surgery and that you have the diagnosis of morbid obesity. It is also very important for your physician to state that he/she has supervised you in diet/exercise attempt that have not helped significantly.