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Unfortunately many insurance plans do not cover weight loss surgery. And even if your plan does cover the procedure you may need additional documentation to prove that you need it.
So if you are serious about bariatric surgery, here are some tips on getting a head start on the insurance approval process.
1. Contact Dr. Syn's office. He has employees who specialize in insurance verification and can assist you in the process. This is a complex process; please enlist the help of our professionals.
2. Contact your insurance company. Read your certificate of coverage and call your insurance customer service line. It is important that you know what your plan will and will not cover.
3. Get proof of unsuccessful weight loss attempts. Contact your primary care physician or other physicians and ask for any documentation they may have of your struggle with obesity and its comorbidities. Also, make sure you ask your physicians to document any weight loss measures they utilize with you. Collect other proof, too. This could include receipts or other documents (from gym memberships, counseling sessions, weight loss program memberships, weight loss medications, etc.).
4. Make a list of your previous weight loss attempts. A self report of previous weight loss attempts may be enough proof. So, start from the beginning and write out all the different methods you've tried. Give the list to your bariatric surgeon. It will probably serve as great motivation for you to follow through with the surgery. After all, weight loss surgery is the only weight loss method where dramatic results are typical.
5. Investigate your appeal process. If you are denied by your insurance company you may want to consider an appeal. There are insurance attornies and insurance advocates available to assist you, often for a fee. There may be a time limit to when you must file an appeal or a maximum number of times you may appeal.
Some policies have very solid exclusions. If your policy has a definite exclusion there is likely nothing we can do to get the procedure covered.
Please call (806)687-5670 to speak with one of our insurance experts if you are interested in weight loss surgery by Dr. Syn.
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