Free insurance verification can give you a much clearer idea of what your health plan may cover before you commit to bariatric surgery. It is not the same thing as final approval, and it does not guarantee what you will pay.
The Weight Loss Surgery Center of Los Angeles accepts most major PPO plans and Medicare patients. When you provide your insurance information, our billing department contacts your insurer directly to find out how much of a proposed procedure may be covered under your plan.
What Can Insurance Verification Help You Clarify?
Insurance policies can look similar on the surface and still handle bariatric care differently. A benefits check gives you a reason to get specific about your own policy instead of relying on a general answer about an insurance company.
Questions worth clearing up include:
- Whether bariatric surgery is included in your plan benefits
- Which procedures your policy may cover
- Whether prior authorization or supporting medical documentation is required
- Whether your surgeon and surgical facility are in network
- What deductible, copayment, coinsurance, or other out-of-pocket costs may apply
Some of those answers may require more than the first benefits call. The point is to identify the questions early, before they become a surprise later in the process.
Does Prior Authorization Mean Your Surgery Is Covered?
No. HealthCare.gov explains that prior authorization is a decision by a health plan that a service or treatment is medically necessary. A plan may require that approval before treatment, but prior authorization still is not a promise that the plan will cover every cost.
That is why bariatric surgery insurance coverage needs to be checked against your actual policy. Verification can help you understand the benefits currently attached to the plan, while final coverage and payment remain subject to the insurer’s requirements.
What Costs Should You Ask About?
At our practice, we divide weight loss surgery costs into three main parts: the surgeon’s fee, facility fee, and anesthesia. During your complimentary consultation, Dr. Davtyan and our team explain the fees involved and answer your questions about paying for treatment.
If you have Medicare, it may cover some bariatric surgical procedures for eligible patients. It also recommends asking the doctor and facility what you may owe because costs can vary. Medicare bariatric surgery coverage still needs to be checked for your individual situation.
FAQ
Can insurance verification tell me whether my bariatric surgery is approved?
No. It can clarify current benefits and help identify requirements, but your insurer may still require documentation, prior authorization, or other review before approving surgery.
Can I schedule a consultation while my insurance is being checked?
Yes. You can schedule a complimentary consultation with Dr. David Davtyan by providing your insurance information. Our billing department can then contact your insurer directly while you begin discussing treatment options.
Get Clearer Answers About Weight Loss Surgery Insurance in Los Angeles
If insurance uncertainty has kept you from seriously exploring surgery, start with your own benefits. Contact The Weight Loss Surgery Center of Los Angeles for free insurance verification and a complimentary consultation with Dr. Davtyan. Our team works with patients from Beverly Hills and throughout Southern California and can help you sort out the coverage questions that affect your treatment planning.
Posted on behalf of Dr. David G. Davtyan MD, FACS, FICS
