Finance Related FAQs
Will my Health Insurance Cover the Cost of Bariatric surgery?
The answer to this question is MAYBE. All health insurance policies are different and the health insurance benefits they cover vary from policy to policy. If there is a specific exclusion for morbid obesity (i.e., weight loss surgery), the insurance company will NOT pay for bariatric surgery no matter what.
The Wellborn Clinic can provide you with a bariatric surgery insurance questionnaire so you can determine if you have health insurance coverage for bariatric surgery.
Unfortunately, The Wellborn Clinic does not accept Medicaid for a primary initial bariatric surgery.
For all other questions about health insurance coverage for bariatric surgery, please contact Nikki at 501-663-9600 ext 110 or email her at email@example.com.
What do I do if I receive a DENIAL from my health insurance for bariatric surgery?
In general, we do our best to make sure we do not receive a denial. We submit a request for a prior authorization for bariatric surgery based on the specific criteria your insurance company requires you to complete in order for them to pay for your surgery. Based on the answers from you Bariatric Surgery Insurance Questionnaire, we submit all pertinent documents to your insurance company. Most of the time we are successful in obtaining this prior authorization. In the event we receive a denial from your health insurance company, we provide the insurance company with any additional documents or support they request. In the event, the request for prior authorization is still denied, we can submit a formal appeal or arrange a peer-to-peer review in the hopes they change their mind. In the end if they deny a final time, you will have to pay out of pocket. Rest assured, that is the last resort.
How long does it take to get a prior authorization for bariatric surgery?
It is difficult to say how long this process can take. Health insurance companies do not make it easy on patients to get a prior authorization for bariatric surgery. Most health insurance companies make you jump through a lot of different hoops in order for them to pay for your surgery. The following are examples of what your health insurance company MAY REQUIRE you to do:
- A 6 Month Physician Supervised Diet
- A Nutritional Evaluation
- A Psychological Evaluation
- A Weight Loss of 10% of your body weight
- A Sleep Study
These items are just EXAMPLES of what they may request of you to obtain a prior authorization. So, the timing varies greatly based on what your health insurance company wants you to do. We will do our best to give you a reasonable time frame of when your surgery can be scheduled once we have all the information we need to submit to your health insurance company.
What if my health insurance policy has an EXCLUSION for bariatric surgery?
If this is the case, there is a variety of financing options available to you. To find out what these are, please contact Nikki at 501-663-9600 ext 110 or email her at firstname.lastname@example.org.
What is the Self-Pay Price of Bariatric Surgery if my insurance does not cover Bariatric Surgery?
The self-pay price of bariatric surgery varies depending on the following things:
- The type of bariatric surgery/procedure you undergo/have (i.e., Gastric Balloon, Lapband, Sleeve Gastrectomy, Roux-en-y Gastric Bypass, etc…)
- The location where the surgery/procedure is performed (Baptist Medical Center or The Little Rock Surgery Center)
- Your BMI and other Co-Morbid Conditions
Please contact Nikki at 501-663-9600 ext 110 or email her at email@example.com to find out the exact price.
What can I expect to pay at the time of my H&P?
Self-Pay patients are required to pay upfront for their surgery/procedure at the time of their H&P with Dr. Wellborn.
Insurance patients are required to put down a $275 insurance deposit at the time of their H&P. This amount will be applied toward any patient responsibility/deductible that is owed once the patient has surgery.
Insurance patients will also be required to pay their deducible prior to their surgery date (up to the “allowable” amount of the surgery). The hospital will collect any out-of-pocket amounts remaining prior to surgery.
General Bariatric Surgery FAQs
How long will I be in the hospital after bariatric surgery and how long is my recovery?
It depends on which weight loss surgery you have. Most, but not all, Lapband surgeries are performed on an outpatient basis and spend less than 24 hours in the hospital. Sleeve gastrectomy patients spend approximately 48 hours in the hospital post-surgery and Rouen-y Gastric Bypass patients spend approximately 72 hours in the hospital post-surgery.
It takes most patients about a week or two (depending on which bariatric surgery you have) to return to work and about a month to six weeks to resume exercising. In the event Dr. Wellborn has to perform an “open” surgery or if there are complications, recovery may take longer.
When can I drive after bariatric surgery?
When you feel alert, can turn about in the car and when you are NO LONGER taking pain medication. This is usually around one to two weeks after surgery.
What is the average weight loss after Bariatric Surgery?
Weight loss is greatest during the first 6 to 9 months after surgery. This is termed the “Rapid Weight Loss Phase.” Weight loss continues at a slower rate for the 9 to 18 months after surgery. Generally, heavier patients lose more total weight but as a percentage of excess weight, most patients lose 35% of their excess weight by 6 months, 60% at 12 months and 72% at 18 months.
How much weight will I lose?
Weight loss results vary from patient to patient. The amount you lose depends upon how compliant you are to following the nutritional guidelines and caloric reduction goals set prior to surgery. Weight loss surgery is a TOOL, not a miracle cure. The pounds do not come off by themselves.
Will I need plastic surgery for the surplus skin when I have lost a lot of weight?
This is not always the case. As a rule, plastic surgery following bariatric surgery will not be considered for at least a year or two after the initial bariatric surgery. Sometimes the skin will mold itself around the new body tissue. You should give the skin the time it needs to adjust before you decide to have more surgery.
Will I have scars from bariatric surgery?
There will be 4 to 5 small incisions for the Laparoscopic Adjustable Gastric Band (Lapband), Laparoscopic Sleeve Gastrectomy and the Laparoscopic Roux-en-y Gastric Bypass. There will be a 4 to 8 inch scar if Dr. Wellborn has to perform an “open” Roux-en-y Gastric Bypass.
What about other medication?
You should still be able to take your prescribed medication after bariatric surgery. You may need to use capsules or break larger tablets in half or dissolve them in water (if necessary) so they don’t get stuck in the stoma and make you sick. You should let your prescribing doctor know you are undergoing bariatric surgery and come up with a game plan for medications you take on a daily basis.
Will I need to take vitamin supplements?
You may. It all depends on which bariatric surgery you undergo. Roux-en-y Gastric Bypass surgery patients will require additional vitamin and mineral supplements. For patients who have the Lapband and the Sleeve Gastrectomy, a good multi-vitamin will suffice.
Will I lose my hair?
Patients may experience hair thinning within 4 to 8 months post op. However, this is usually a temporary condition and our staff can provide medical assistance with this matter.
Is it okay to drink alcohol after bariatric surgery?
Alcohol has a high number of calories. It also breaks down vitamins. An occasional glass of wine or other alcoholic beverage, though, is not considered harmful to weight loss.
What about pregnancy after bariatric surgery?
It may become easier to get pregnant as you lose weight. Your menstrual cycle may become more regular. Pregnancy should generally be avoided (if possible) during the first 18 months of your weight loss journey or reached your goal weight.
If you become pregnant and have undergone the Lapband surgery, the Lapband can be loosened so you can consume more nutrition during pregnancy. It can be tightened back up again after child birth so you can resume losing weight.
Will I regurgitate a lot after Bariatric Surgery?
Not necessarily. It is true that if you eat too much or eat too big of a bite following surgery, you may have to excuse yourself to go to the bathroom to regurgitate. As long as you remember to chew your food and eat slowly, this should not be an ongoing problem.
Can I eat anything in moderation?
After your stomach has healed, you should be able eat most foods, just not in large quantities. However, because you can only eat small portions, it is important to include foods full of important vitamins and nutrients. If you eat foods that contain a lot of sugar and fat or drink liquids full of “empty” calories, such as milkshakes, the effect of the bariatric surgery may be greatly reduced or cancelled out.
Can I regain the weight after bariatric surgery?
Any weight gain after bariatric surgery is almost always caused by not following the dietary rules. For example, habits such as drinking with your meals, eating small amounts of high calorie foods throughout the day and eating softer high fat foods (cookies/cake) or high carbohydrate foods (loaded mash potatoes) rather than solid foods (proteins and veggies) can actually cause weight gain. While obesity surgery usually works, it only helps with weight loss and is not “magic”, not is weight loss guaranteed.
What is the mortality rate following bariatric surgery?
The national mortality rate for bariatric surgery is between 0.2% to 0.5% or 1 in 500/200 patients.