Insurance and Financial Information
The Center for Surgical and Medical Weight Loss is sensitive to the cost of surgical weight loss. That’s why we have designed our services to keep costs down, the prices competitive, and to help you maximize your insurance benefits. If you have a bariatric exclusion from coverage, we offer self-pay pricing and financing options to assist you.
For more information
I don’t know if I have bariatric benefits…
Our Insurance Specialists and Patient Advocate are ready to assist you. Your insurance company will be contacted by one of our specialists for verification, and in turn, we will contact you to help you understand your benefits. A customized checklist with the steps that your insurance company requires of you prior to surgery will be provided to you by our Patient Advocate.
My insurance doesn’t cover bariatric surgery…
Your patient account can be designated as “self-pay” for bariatric services. You will be provided with self-pay fees information that are bundled and discounted. Financing options are also available for you to consider.
I am self-pay for surgery. When do I pay the surgery fee?
Payment is due in full at the time of your pre-operative appointment which is approximately two weeks prior to surgery.
What forms of payment do you accept for self-pay surgery?
We accept credit card and cashier’s check. Please contact our front desk at 615-284-2400 for specific details.
I have bariatric coverage, who will submit my claim to insurance?
The Center for Surgical and Medical Weight Loss will submit your claims to your insurance company if you have bariatric benefits. Claims may be covered, denied, or partially covered by your insurance company.
Will I receive a bill if I have bariatric benefits?You may receive a bill for an amount your insurance company deems is your share of the responsibility. This can be due to a deductible and/or an amount that is not covered by your plan, or a percentage portion that is shared between you and your insurance company.
Will I have a co-pay?
For patients with bariatric coverage, a specialist’s co-pay may be required by your insurance company at the time of your visit. There are no co-pays for self-pay patients. However, a fee for services rendered may be due at the time of your visit.
I received a pre-determination of benefits, will I receive a bill?
Please be aware that a pre-determination of benefits may not guarantee payment of services by your insurance company.
Do I need a pre-authorization for surgery?
It depends on your insurance plan which your insurance specialist will verify. Your insurance specialist will also be responsible for submitting the pre-authorization request for surgery and obtaining it on your behalf. You are responsible for following the program steps the Patient Advocate has laid out for you, and providing any required documents to the insurance specialist such as, a letter of medical necessity from your primary care physician.
Do I need a referral to come to the Center for my first appointment?If you have an HMO, you will need a referral from a physician. Otherwise, it depends on your insurance plan and your insurance specialist will verify that for you beforehand.
Insurance and Financial Information
Insurance Liability for Payment: Your health insurance company will only pay for services that it determines to be reasonable and necessary. Every effort will be made by this office to have all services and procedures covered by your health insurance company. If your health insurance company determines that a particular service is not covered under your plan, your insurer will deny payment for that service.
It is YOUR responsibility to know your insurance benefits. At the time you become a participating member of your insurance company, you are given access to a policy and identification card. Please review your policy and/or contact the customer service number on the back of your ID card and request the benefits department. We encourage you to confirm your benefits as we cannot guarantee coverage.