Getting Started
By now, you should have determined that you meet the basic criteria for LAP-BAND® System surgery and that you are ready to commit to a change in your life-style.
Step One:
If you have medical insurance, you will need to determine if your policy covers any or all of the included costs, such as the surgery itself, the surgery center, the anesthesia, the provider and the consultation and follow up appointments. Insurance coverage varies between providers and even between employers using the same provider. Therefore, you will need to check your individual policy to see if it specifically excludes weight loss (or bariatric) surgery. If you are unable to find the answer by reading the policy, you should call your provider or health plan administrator and ask them specifically; “Does my insurance policy cover Lap-Band surgery?” We can also contact your insurance company for you after your initial consultation.
If the answer is “Yes,” make a list of their criteria and conditions. Many providers will also require that you have one or more of the following prior to approving coverage: Psychiatric evaluation, Sleep Apnea study, cardiac evaluation, and family physician recommendation.
If the answer is “No,” ask if this is based on a “written exclusion” in the policy. If there is a written exclusion, there is little you can do other than change insurance carriers. If there is not a written exclusion, you should ask why Lap-Band surgery is not covered. Unfortunately, there are some insurance companies that will initially deny coverage (even without a written exclusion) in hopes that you’ll give up, so be persistent. You may also want to check the ObesityHelp.com database of Insurance Providers & Government Programs to see if others have been approved or denied by your provider.
If you do not have insurance or your insurance will not cover the procedure, we work with healthcare finance compaies with competitive rates.
Step Two:
Once you have determined your method of payment, your next step should be to attend one of the weight loss surgery seminars conducted by Dr. Luttrell. Our staff will be happy to provide you with a reservation. It is important to call our office to reserve a spot as we like to keep the seminars intimate.
Step Three:
Schedule a pre-surgery consultation meeting with Dr. Luttrell. (A friend or significant other may participate if you like.) During this consultation, Dr. Luttrell will:
- Review your medical history with you.
- Explain the surgical procedure, risks and possible side effects.
- Discuss the minor pitfalls you may have.
- Answer any questions you may have.
- Obtain written permission to contact your insurance provider should you decide to have surgery.
For your convenience, we have posted our Patient Medical History Form and Patient Information Form on the bottom of this page. You may print them, fill them out and bring them with you to your consultation in order to reduce your waiting time. You may fill out the forms at the time of your consultation; however, we ask that you arrive at least 30 minutes prior to your appointment time if you prefer to fill out the form in our offices.
Step Four:
If you are paying cash, we can schedule your surgery date during your consultation unless you would like more time to make a final decision.
If you will be relying on insurance for payment, Dr. Luttrell will dictate a letter of “Medical Necessity” and we will request “pre-certification” from your insurance provider. Depending on your medical case and your insurance provider, this process can take anywhere from a few days to several months. The process may also include providing them with any other documentation they request from our office, other physicians or clinics involved in your medical care, and/or directly from you. Once our letter is sent, you can help keep the process moving by contacting your insurance company at regular intervals to determine the status of your request. We will also periodically check status.
Our staff will work hard to obtain insurance approval for your procedure by responding to any requests the insurance company makes and we are always happy to answer any questions you may have during this period.
Step Five:
Once we receive approval from your insurance provider, we will contact you to schedule a date for your surgery and any pre-surgical tests that will be required.
Step Six:
Surgery, recovery and learning to live a thinner life!
