Pathway to Surgery

Begin Your Weight Loss Journey

Interested in beginning your weight loss journey, but what to learn more? Participate in one of our webinars.

Call or email us so we can verify your insurance coverage, benefits and any criteria your insurance plan may require for your approval for surgery.

Staying on Course with Your Weight Loss Journey

Complete a psychological evaluation to insure you’re properly prepared to make lifestyle changes after surgery (we will provide you with provider options)

Begin attending support group so you can meet others who have “been there, done that” (everyone is expected to attend at least one group prior to surgery)

Navigating the Insurance Waters During Your Weight Loss Journey

Our insurance specialists will work directly with your insurance company, your surgeon and your physician(s) to insure the highest likelihood of approval by your insurance company.

Should your insurance company deny the request for surgery or you do not have insurance coverage for surgery, we have self-pay rates available.

Insure Smooth Sailing Throughout Your Weight Loss Journey

Participate in as many support groups as you can before and after surgery to increase your knowledge, make new friends and find multiple sources of support.

Prepare in advance by reading and re-reading your Owner’s Manual, make a list of questions to ask at the preop. class.

Am I a Candidate? Calculate Your BMI

There are many factors to determine if you’re a candidate for weight loss surgery. Please read all of the details below. Call us or contact us today to schedule your evaluation or if you have any other questions or concerns.

BMI	Classification	Health Risk
Under 18.5	Underweight	Minimal
18.5 – 24.9	Normal Weight	Minimal
25 – 29.9	Overweight	Increased
30 – 34.9	Obese	High
35 – 39.9	Severely Obese	Very High
40+	Morbidly Obese	Extremely High

Where do you stand?

If your BMI was higher than 30, you may be an eligible candidate for weight loss surgery.

Find Yours

40+

Morbidly Obese

A BMI greater than 40 indicates severe obesity. This level of obesity puts you at greatest risk for of obesity-related health conditions such as type 2 diabetes, obstructive sleep apnea, high blood pressure, osteoarthritis, heart disease and risk of premature death.

Currently, many insurance companies do cover weight loss surgery for those within this range of BMI if coverage was purchased by their employer. To learn more about surgical treatment options, click here to register for our online webinar.

Take the First Step

39.9-35

Severely Obese

Based on the height and weight you entered, you fall into the severely obese category.

Take the First Step

34.9-30

Obese

Based on the height and weight you entered, you fall into the obese category. Being affected by obesity is associated with a higher risk of heart disease and diabetes, particularly if your body fat is concentrated around the abdomen.
In addition to the suggested lifestyle choices listed below, weight loss medications may be an option for those in the obese category.

Lifestyle choices that can lead to weight loss include:

Making healthy food choices like lean proteins, fresh fruit and vegetables and avoiding simple sugars high-calorie beverages
Incorporating more physical activity into your daily routine – park further away from the entrance, taking the stairs
Developing an exercise routine – commit 45 to 60 minutes a day or several times a day in 5 to 10 minute intervals
Breaking your learned habits of eating (cleaning your plate, afternoon coffee break, rewarding yourself with food, eating to quickly)
Developing new habits of eating (eat when you are truly physically hungry, not in response to emotions, buying only healthy options, avoiding trigger foods)

Currently, the majority of insurance companies do not cover weight loss surgery for those within this range of BMI; however, you may be a candidate for either laparoscopic adjustable gastric banding or the gastric balloon as a self pay patient.

29.9-25

Overweight

Based on the height and weight you entered, you fall into the overweight category. Keep in mind, BMI does not take into account muscle mass, which means not everyone with a BMI in this range needs to lose weight. Being overweight is associated with a higher risk of disease, particularly if your body fat is concentrated around the abdomen.

Lifestyle choices that can lead to weight loss include:

Making healthy food choices like lean proteins, fresh fruit and vegetables and avoiding simple sugars high-calorie beverages
Incorporating more physical activity into your daily routine – park further away from the entrance, taking the stairs
Developing an exercise routine – commit 45 to 60 minutes a day or several times a day in 5 to 10 minute intervals
Breaking your learned habits of eating (cleaning your plate, afternoon coffee break, rewarding yourself with food, eating to quickly)
Developing new habits of eating (eat when you are truly physically hungry, not in response to emotions, buying only healthy options, avoiding trigger foods)

At this level of BMI, the combination of dietary changes and exercise is often enough to bring your weight to a healthier level. For additional resources, our dietitians, exercise physiologist, psychologists and physicians create custom weight loss plans.

24.9-18.5

Healthy Weight

Congratulations! Your BMI is considered in the healthy range based on the height and weight you entered. Healthy food choices and regular exercise are the key to maintaining a healthy weight, especially as you become older.

18.5-

Underweight

Based on the height and weight you entered, you fall into the underweight category.

Ready to Act?

To see if your insurance company covers weight loss surgery, please complete our online questionnaire. If you do not have insurance coverage for weight loss surgery, please click here to view our self pay options.

If you still have questions on how to calculate your BMI please visit our contact us page or call 615-342-1231.

Bariatric Surgery Insurance

Insurance Patients:
The bariatric surgery insurance approval process can be challenging. Our dedicated insurance specialists help you successfully navigate the approval process. We will:

Verify your insurance benefits and criteria specific to your plan
Provide the estimated out of pocket amount based on your insurance coverage
Obtain medical records, referral letters and any other documentation required by your insurance
Work with your insurance company to obtain approval for surgery
Keep you informed and updated every step of the way

Our surgeons and medical center are in-network providers for most insurance plans. Criteria for bariatric (weight loss) surgery insurance can vary greatly by plan and by employer. Most insurance companies base criteria on the following National Institutes of Health guidelines:

BMI of 40 or greater
BMI of 35-40 with significant obesity related health condition such as, type 2 diabetes, high blood pressure, sleep apnea, arthritis and other conditions
Documented dietary attempts ineffective
Multi-disciplinary team approach
Life-long medical surveillance
These requirements only apply if surgery is a covered benefit under your policy. Some policies have exclusions, which means your insurance plan does not cover these services.

Self Pay Bariatric Surgery

Not everyone has insurance coverage for weight loss surgery. If you choose to pay for surgery yourself, our plans provide options for unexpected concerns. Our self pay rate for gastric banding, vertical sleeve gastrectomy and gastric bypass includes coverage of complications or readmission to the hospital for 90 days after your procedure.

Most importantly, our self pay rates include unlimited access to our registered dietitians, exercise physiologist, support groups and our Psychological Support Program. Some patients choose to borrow against their 401K plans or to utilize home equity loans. If you need assistance with financing your surgery and work with healthcare finance companies, please be aware most finance companies charge fees. You may need to borrow a greater amount to insure you have the full amount.