Insurance

Below we have listed some codes to help you find out if your insurance covers Bariatric Surgery. You will need to call the customer service number on the back of your card, and ask the following questions:

Are Bariatric Surgery (CPT Code 43770 for Lap-Band and CPT Code 43775 for the Gastric Sleeve) and the treatment for morbid obesity & weight loss (diagnosis Code 278.01) covered benefits?

Does your policy have an exclusion for weight loss surgery?

If you have a policy exclusion, your insurance will not pay for the surgery. If you would like help with financing options please email Heather Earheart, or go to the Financing Page for more information.

Primary diagnosis is Morbid Obesity 278.01
The CPT (procedure) code for the LAP-BAND^® is 43770
The CPT (procedure) code for the Gastric Sleeve is 43775

If your insurance company states that it is a covered benefit, or if they say they will cover if "medically necessary", please contact us for an appointment, and let us get started on your case today.

The following items may be required in order to submit to insurance.  Insurance requirements vary according to your policy.

1. The patient information profile completely filled out.
2. Any letters or medical records from other health care providers referring to weight related medical issues.
3. A recommendation for weight loss surgery from your primary care physician
4. Any documentation proving you participated in any diet / weight loss attempts. (This includes office notes, receipts or prescriptions) Some insurance companies will require a history of morbid obesity spanning 2-5 years.
5. A copy of your insurance card.
6. A copy of your driver's license
7. If your insurance plan requires a referral for this consultation, please contact your primary care physician and have one faxed to this office before the appointment.

Please be aware the insurance company has to review your case and make a decision based on their criteria.  Once your paperwork is submitted we have no control on how fast they deliver their decision.  If you would like to check on your status please contact us or call your insurance company.  In many cases, you will be notified before we are by your insurance company. We can only use approvals that are in writing.

Please call our main office number for an appointment.

817-850-1100

Your insurance company may require a co-payment.
Please be prepared to pay your co-payment at the time of service.

ADDITIONAL EXPENSES: Like any other outpatient elective surgery, you may have a co-pay, deductible, or out-of-pocket expenses dictated by your insurance policy that you will be required to pay.