Program Process

Call

The first step is to call us toll-free (886) 992-6443 x1 and let us discuss your interest in weight loss surgery. Once we determine you are a candidate, you will be invited to attend one of our free, educational seminars.

Seminar

Our seminars are facilitated by Weight Loss Surgery Specialists staff members. The seminar includes an overview of our program, including information on all treatments for morbid obesity, as well as surgical options and the risks and benefits of each. You will have the opportunity to ask questions of patients who have had bariatric surgery. We will also provide you with information about the insurance approval process.

If you decide you are interested, you will need a copy of your insurance card and picture ID to go along with your completed health history form.  You are welcome to do your health history form online in the comfort of your own home.  You will be weighed; your height measured and your vital signs checked.

Medical Acceptance

The National Institutes of Health has set forth guidelines to determine who is an appropriate candidate for weight loss surgery. Your insurance company and our surgeons follow these guidelines.

Once you have attended the seminar, one of our surgeons will review your health history form, along with your height and weight, to determine if you meet National Institutes of Health criteria. To be considered a candidate for surgery, you must have a BMI of 40 or higher or a BMI of 35-39.9 with certain co-morbid conditions. Once the surgeon determines that you are a candidate based on BMI and your health history, your case will be assigned to a weight loss surgery case manager.

Bariatric Benefits Verification

We will contact the benefits department of your insurance company and ask several questions. If you called prior to attending the seminar, you probably talked to customer service and were automatically told all medically necessary treatment is covered. Unfortunately, some insurance companies and employers have decided to put exclusions in health insurance policies. So even if the surgeon deems it medically necessary, you may not have coverage for this particular health problem and treatment, and may have to consider privately paying or changing policies. We will determine if you have appropriate coverage for the surgical treatment of morbid obesity and if so, what requirements your insurance company will have. Every insurance company has different rules, and your specific policy may have different requirements. We will call you within 48 hours of attending the seminar and let you know the status of your case, and if you are/are not accepted as a patient and if you do/do not have coverage.

Insurance Processing

You have been accepted as a patient and you have benefits to proceed with surgery. Now we must get you approved. Again, each insurance company has different requirements for approval and your individual policy may have additional requirements. We may need to obtain up to five years of medical records to document your history of morbid obesity, we may need to obtain all of your diet records and you may need to have several months of medically supervised diet in order to get approval. If this is required, it is the perfect opportunity to make changes to optimize your post-operative success. Or, you may not need much; it just depends on your insurance policy.  The good news is that we can help you get whatever it is that is required. We are experts at getting this done! If for any reason your particular policy has a requirement that is impossible to meet or if for some reason you receive a denial of approval, we have an Appeals Coordinator who will work hard to overturn your case. Once we get everything together, we will submit the final medical file to your insurance company and follow up closely. Bariatric surgery is the only medically necessary treatment that requires written approval from your insurance company. Until we receive the written authorization, we cannot proceed with surgery.

Pre-Operative Testing

You're approved and now you are moving toward a surgery date. The first thing we determine is when you want surgery. Once we have an idea of when you can have surgery based on your schedule and the surgeon’s schedule, we need to get all of your pre-operative testing completed. Pre-operative testing requirements are individualized to your health history, current medical conditions and BMI. The procedure you are having will also determine what testing will be required. All of our surgeons carefully evaluate your individual risk factors and will order testing accordingly. If they order it, there is a sound medical reason and it will be required prior to surgery. If results come back abnormal, your surgeon may order additional tests. We will set up your testing, and once we get all of the test results back, we can proceed with the next step:  Pre-operative education and your one-on-one appointment with the surgeon.

Pre-Operative Education and Informed Consent

You will attend a pre-operative meeting facilitated by our dietitian. During this session, you will go through an extensive informed consent process and sign several documents. We strongly encourage you to bring a family member or friend. You will also receive extensive education about your procedure and the post-operative diet. You will be given everything in writing and you will receive a copy of Your Journey, a manual prepared just for you to help you achieve success after surgery. You will have all the time you need to ask all of your questions about your post-operative diet and follow up care. You will also be required to attend a support group meeting prior to your surgery date. You must sign a Bariatric Commitment, which indicates your commitment to following the requirements, recommendations and follow-up schedule.

Pre-Operative History And Physical

One to two weeks prior to having surgery, you will have an appointment with the surgeon. Prior to this time, your surgeon will have all of your test results. During this visit, your surgeon will conduct your history and physical (a review of your health history, current conditions, test results, your current medications and conduct a physical exam). Your surgeon will review the surgical procedure, discuss the risks of the surgery, review informed-consent, and answer any questions you may have. We also strongly encourage you to bring a family member or friend to this visit. If there were any abnormal test results or there is a problem with proceeding with surgery, your surgeon will discuss it with you at this time.

Your next step is Surgery!

You may contact us if you have any additional questions.