Insurance and Financing
Call 937-886-4199 or Register for a Free Information SeminarWhen you finally make the life-changing decision to have surgical weight loss, the insurance part of your life should be easy. At Springfield Regional Weight Management Solutions, that's what we strive for.
Our program accepts most major insurance plans, so we know the pre-authorization process inside and out. If you have questions about your insurance requirements, or are just a bit overwhelmed, call us at 937-886-4199. We'll be happy to answer questions about your specific insurance coverage and help you get started with the pre-approval process for bariatric surgery.
We know that dealing with your health insurance coverage can seem like a maze, but no matter what kind of insurance you have, our unmatched support team is here to guide you every step of the way.
Paying For Surgery On Your Own?If you're a private-pay patient, we also offer a unique expedited surgical option that takes previously unsuccessful diet and exercise attempts into account and may put you on a fast track for bariatric surgery.
Finally, bariatric surgery is not eligible under the financial assistance or discount programs offered by Community Mercy.
Once you have made the decision to have surgical weight loss, getting your bariatric procedure approved by your insurance company is the next step. At Springfield Regional Weight Management Solutions we work with you and help you understand your insurance benefit and also work with you to obtain all of the clinical information and documentation that is required. Many insurance companies mandate certain criteria that have to be met before any documentation is sent to the insurance company for approval and this is based on the medical policy of the insurance company.
Our program accepts most major insurance plans, so we deal with pre-authorization requirements every day. If you have any questions about your coverage, or are a bit confused, call us at 937-886-4199. We’ll be happy to answer your questions and guide you through every step of the process.
Here are some requirements that your insurance company may need:
- A letter of medical necessity – from your Primary care physician
- Your BMI ( body mass index ) must be 35 or more and you must have at least one of the following;
- Sleep apnea
- High cholesterol
- Or your BMI is 40 or more, without any of the conditions above.
- A psychological evaluation to make sure the patient has a clear understanding of weight loss surgery and the impact it will have on one’s lifestyle. The psychological evaluation also checks for untreated binge eating or any other psychological issues.
- A nutritional evaluation – working one-on-one with a dietician – to outline specific dietary changes and make suggestions on specific habits that need to be changed.
- Complete a three – nine month medical weight loss program supervised by a physician (with monthly weigh-ins) and provided documentation. Your insurance determines the number of months needed.
- Medical clearances
If your insurance carrier will not cover weight loss surgery, and you are interested in being a private-pay patient, please call us at 937-886-4199 and we will go over our private pay rates with you.
Expedited Surgical OptionMost insurance companies require you to be on a medically supervised weight loss program before they will cover your surgery. If you've been unsuccessful on a medical diet program in the past, the thought of having to go through it again just to get your insurance company to approve your bariatric surgery can be really frustrating.
We heard this from a lot of potential patients, so we came up with a faster solution called our expedited surgical option, which may put you on a fast track for bariatric surgery. In fact, Springfield Regional Weight Management Solutions is the only program in the Springfield area that offers people who are financing their surgery privately (not through their insurance) this unique, life-changing choice.
Here's how it works: If you're a private-pay patient, this option recognizes your previously unsuccessful diet and exercise attempts and eliminates the need for yet another lengthy medically supervised weight loss plan dictated by your insurance company. But, most important, it can get you into surgery faster so you can get on with your new, healthy life.
You Still Must Be Medically ClearedIf you select the expedited surgical option, it doesn't mean you get to "skip" the medical, nutritional and psychological evaluations required of every surgical weight loss candidate. It simply means you get to forego an unnecessary, time-consuming medically supervised weight loss program if bariatric surgeon Dr. Magued Khouzam, is satisfied with your past unsuccessful diet attempts using programs such as Weight Watchers®, Jenny Craig®, Nutrisystem®, Slim-Fast®, HMR®, Medifast® and others.
Included In Springfield Regional Weight Management Solutions' Private Pay Package
- 3 Follow-up visits after surgery within 90 days of your surgical procedure with bariatric surgeon Dr. Magued Khouzam, (visits at two, six, and 12 weeks after surgery)
- Individual dietary sessions and coaching
- Monthly or weekly support groups focused on procedural information, planning, behaviors, emotional and family support, and more
- Access to our 24/7 nurse hotline and more
If you have questions about our expedited surgical option, or would like to learn more about this private-pay option that may put you on a fast track for bariatric surgery, please call our office at 937-886-4199 and we'll be glad to help.