Paying for Surgery

Most plans require documented failure of conservative treatments and high patient motivation before approving surgery.

Insurance coverage often requires a lengthy and complicated approval process.
 

The following information is generally included in the pre-authorization letter to the insurance company, to establish the "medical necessity" of weight loss surgery and gain approval for the procedure:
     Patient height, weight, and Body Mass Index
     A full description of all the patient’s obesity-related health conditions
     A detailed description of the daily activity limitations
     A detailed history of patient’s dieting efforts, including medically and non-medically supervised programs
     A history of exercise programs
     Information from medical journals regarding the effectiveness of weight loss surgery

*The number one reason insurance companies deny authorization for surgical weight loss is the lack of documentation of physician supervised weight loss attempts.

Baptist Hospital is in network for most insurance companies.
Dr. Spaw is in the following:

Blue Cross/Blue Shield
Aetna
Cigna
United Healthcare

Medicare patients, both Baptist hospital and Dr. Spaw have received the ASBS Center of Excellence designation; however, Dr. Spaw is not a Medicare provider. What does this mean? It means you can have Dr. Spaw perform your surgery at Baptist Hospital, Medicare will cover the hospital stay, Dr. Spaw’s fee is the patient’s responsibility; please call our office for further details.

If your surgery is not covered by your insurance or you prefer to pay privately, please contact our office to make arrangements.