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 line on the back of your card and ask the following questions:
Are Bariatric Surgery (CPT Code 43770) and the treatment for obesity & weight loss (diagnosis Code 278.01) covered
benefits?
Are there any exclusions for the treatment for obesity on your policy.
If the answer is no to either one of these questions your insurance will not pay for the surgery. We would like to help
you 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
If your insurance company states that it is a covered benefit or if they say they will cover if "medically necessary"
Please send the following information to Nancy and let us get started on your case today.
- The patient information profile completely filled out.
- Any letters or medical records from other health care providers referring to weight related medical issues.
- A recommendation for weight loss surgery from your primary care physician
- Any documentation proving you participated in any diet / weight loss attempts.
(This includes office notes, receipts or prescriptions) Most insurance companies require proof that you have tried
for 5 years.
- A copy of your insurance card. Back and Front please.
- A copy of your Driver's License
- 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 90 days to make a decision. 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 Nancy (by email only if
possible) 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.
Once we have an approval from your insurance company or you have chosen a method of payment for the procedure you will need
to make your appointments for your Psychological Evaluation and Nutrition Assessment. When we have the reports it is time to
make an appointment with Dr. Smith.
Please call our main office number for that appointment.
817-850-1100
You may be required by your insurance to provide a co-pay.
The co-pay must be paid before your appointment.
ADDITIONAL EXPENSES: Like any other Outpatient Elective surgery, you may have co-pay, deductible, or out-of-pocket
expenses that you will be required to pay to the you have your surgery at for that amount.
If you would like to research your policy online we hope some of these Medical Policy Sites will help.
If you cannot find your company’s site on this list please refer to you policy.