How Quickly Can You Get Bariatric Surgery?
Many of our patients are excited when they decide bariatric surgery is the right option for their weight loss and future health. For most, it is a decision, years or even decades in the making. Many have tried and failed with diet after diet, finding themselves frustrated, regaining weight, and sometimes putting even more on. This weight loss, weight gain cycle can foster disappointment and eventually resign them to thinking that they are stuck with a lifelong weight issue and the diseases that come with it. It’s also important to acknowledge that the cost of bariatric surgery, whether using insurance or not, is significant and requires emotional dedication. There is a potential and major financial investment associated with weight loss surgery.
However, the most frustrating aspect of bariatric surgery, both for our patients and us as surgeons and healthcare practitioners, is the wait many patients experience before they can have surgery. An avalanche of data shows that bariatric surgery is the only long-term effective weight loss option for morbidly obese people. It would seem obvious, therefore, that surgery should be approved immediately, giving our patients the best chance of a renewed life and health. However, insurance companies are adamant about what they call “medical necessity,” a relatively arbitrary term. As such, patients must submit “proof” that they need the surgery, a process that can take up to six months and almost always includes initial testing, a 3 to 6-month preoperative medical weight loss program, documentation of failed weight loss attempts, and several attestations from primary care physicians, and medical specialists.
What Can You Do to Shorten the Time?
Each insurance company is different, and each plan may have specific stipulations. If a friend or family member has been covered or had specific financial responsibilities, the same will not necessarily be true for you. Of course, we will also work with you to determine what benefits you have and what out-of-pocket expenses you should expect to pay. Similarly, we will help you through the preoperative process, assisting you with the paperwork and clearances necessary to move forward. With that said, our best advice is to be organized. Once you know you are choosing surgery as the way forward, start building a file on your health. This will include any testing you’ve already had, and you will want to speak to your primary care physician to schedule additional tests to satisfy insurance requirements. Get the easy stuff out of the way first and start documenting past and current weight loss attempts to ensure you have a complete file. You may even need to provide images that show your weight status over time. This will not necessarily shorten the process – some stipulations like a three or six-month medical weight loss program can’t be changed – but to avoid a pre-authorization denial due to clerical errors or omissions. After all, insurance companies are busy, and while denial can be resubmitted and reviewed, it may take some time and further extend your wait.
In Choosing the Cash Pay Option
Of course, for those with higher deductibles or those that can afford the cost of bariatric surgery, Dr. Chang offers a gastric sleeve for under $9000; this is a cash-pay option – you pay out-of-pocket for the procedure.
Some patients will note that the cash-pay cost will be similar to their medical insurance deductible. There are pros and cons to looking at it that way, but ultimately, you must take your complete financial picture into perspective to make an appropriate decision. Paying cash for your surgery can skip some of your insurance company’s most difficult and time-consuming requirements, like the three or six-month medical weight loss program. However, be mindful that if your health status, and BMI, do not make you a good candidate for surgery, paying cash will not get you surgery when you wouldn’t otherwise qualify. We have internal practice guidelines to ensure the safety and effectiveness of the procedure.
The Bottom Line
Most importantly, the first step toward changing your life is making the decision. We encourage you to watch our online seminar to help you understand the ins and outs of bariatric surgery. You will also meet Dr. Chang and learn more about his qualifications and what it means to choose our practice. Beyond that, your first consultation is a great time to ask plenty of questions about the process and what to expect. We encourage you to list questions but also want you to research online. Much of what you will read may only apply to some situations; an educated patient is likelier to make the best decision and will give themselves the best opportunity for success after surgery.
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