How to Get Insurance to Cover Bariatric Surgery

One of the most complicated parts of getting bariatric surgery is working out the costs associated with such a procedure. Make sure that you have enough financial resources to support your treatment, as the surgery is very expensive. Follow these steps to get insurance to cover your bariatric surgery.

Instructions

Difficulty: Moderate

1. With your surgeon, determine the financial considerations that will go into the bariatric weight loss surgery and follow-up. The two considerations will depend upon the complexity of the surgery.
2. Read the "certificate of coverage" of your insurance company. Get the certificate from your employer’s benefits administrator or from the insurance company itself.
3. Obtain a referral letter from your primary physician or get your doctor’s support for proof of your health conditions.
4. Maintain accurate health records and receipts of your health-related treatments for evidence. They may be needed for inquiry purpose by the insurance company.
5. Keep records of all the documents containing information about your visits to health care centers like weight loss programs, fitness clubs, and diet control centers.
6. Ensure that your surgeon has all the required information to submit to the insurance company for your insurance claim.
7. Review the paperwork with the surgeon to insure that it has been completed the right way. Make sure that the papers contain all the required information about your health conditions.
8. Contact the insurance company once every few weeks to ask about the progress of your claim. Meanwhile, get yourself ready for an appeal in case the insurance company rejects your pre-authorization.
9. Prepare an appeal letter during the approval period. Get it signed by your surgeon or doctor. Send it in if your first claim is rejected. Insurance companies will generally respond to these appeals.