INSURANCE AND FINANCING
Insurance & Payment Options
Weight loss surgery (also known as bariatric surgery) is not universally covered by insurance companies. However, many have begun offering coverage, and it’s important to contact the company and verify whether or not you have weight loss surgery financing coverage, and whether that coverage applies to surgery at Roller Weight Loss & Advanced Surgery.
SUBMIT A LOAN INQUIRY
There are a variety of circumstances you may encounter regarding your health insurance:
Your carrier does not give a definitive answer regarding coverage. Some carriers will wait until documentation is received proving the medical necessity of the procedures, while others will immediately approve or deny coverage. We will work with you to satisfy your carrier requirements.
As you explore whether or not you have coverage, we will be available to answer any questions you may have about what to tell your carrier.
Note: Obesity and morbid obesity are considered separate health conditions. Some plans exclude treatment for obesity but will cover treatment for morbid obesity. Be very specific when describing your condition to your insurance company. If you are unsure about which condition you have, we can help you make that determination.
GETTING APPROVAL
Insurance companies that cover weight loss surgery (bariatric surgery) have benefit guidelines, or specific requirements that must be met before coverage for surgery is authorized. We will do our best to help you, but the process can be long and sometimes confusing, requiring a great deal of effort on the part of the patient and our office. In order to begin pre-certification for coverage, our office must receive:
- Psychological Evaluation.
Psychological assessment of your state of mind and readiness to have surgery and deal with its aftermath. - Medical Records.
Your history of surgeries, medical conditions, medications, and diseases. - Letter of Medical Necessity.
A letter from the patient’s Primary Care Physician documenting that the patient suffers from severe or morbid obesity, has failed multiple different diet and exercise plans, and would benefit significantly from losing a significant amount of weight.
OTHER OPTIONS
CO-PAY & CO-INSURANCE
Out-of-pocket costs to you will vary based on your insurance policy, and we will need to review your policy terms before we estimate the amount you will have to pay. Payment of copay and coinsurance is required 10-14 days prior to your scheduled surgery date. Our financial counselor will estimate your co-insurance payment. Payment must be paid in full prior to surgery.
SELF-PAY
- American Express
- Visa
- MasterCard
- Discover
- Cashier’s Check (no personal checks)
The cost of the operation includes:
- Hospital charges (assuming an average hospital stay without complications)
- Surgeon’s fee
- Surgical assistant’s fee
- Anesthesiologist’s fee
- Pathologist’s fee
- X-Ray charges
This fee only covers routine service related to the surgery and is based on usual and customary charges. The fee estimate will not include:
- Pre-procedure office visits
- Post-procedure office visits
- Diagnostic testing
- Other professional services required as a result of a complication
- Other services provided unrelated to weight loss surgery
Financing
If your insurance carrier does not provide coverage for weight loss surgery (bariatric surgery) or provides incomplete coverage, self-paying is an option. However, we understand that some of our patients may need assistance. We offer multiple options for financing, including:
