From Revisions to Success: Demystifying Bariatric Surgery Policies

Bariatric surgery can be used to treat obesity and associated diseases like diabetes, high blood pressure, and sleep apnea. Family physicians are increasingly seeing patients interested in weight loss surgery. Success after bariatric surgery depends on a permanent lifestyle change that includes diet modification and regular physical activity. Lifelong vitamin and mineral supplements are also recommended.

Preparation

Meeting specific criteria is necessary to qualify for bariatric surgery revision policy. Your BMI must be 40 or higher, and you must have a serious weight-related health condition like diabetes or high blood pressure. You must also agree to adhere to the surgery’s long-term nutritional and exercise requirements. The first step is to attend a particular orientation class. The three-hour course provides a detailed overview of the procedures available, including their risks and benefits. You’ll learn how to prepare for the changes after the operation, such as eating smaller meals and chewing more thoroughly than usual. You’ll also learn to avoid food triggers, such as comfort or emotional eating.

You’ll also undergo a medical evaluation and lab tests to ensure you’re healthy for surgery. These tests may include a blood and urine test, a cardiologist evaluation, and a gastroenterology examination. Your surgeon will review your results and recommend a procedure. The most successful patients follow their doctor’s instructions for post-surgery recovery. It includes avoiding foods that don’t provide the essential nutrients. You should also begin an exercise program, such as walking. It will help reduce bloating and soreness in the abdomen and encourage a more rapid post-surgery weight loss. You’ll also need to take medication to prevent an infection. You’ll spend a few days in the hospital, depending on your specific surgery.

Cost

Bariatric surgery can cost anywhere from $7,500 to more than $30,000 without insurance—the more complex the surgery, the higher the price. However, the cost can be less than what you’ll spend on health care associated with obesity, which includes costly complications. Studies show that the average person who undergoes weight loss surgery pays 42% less in health care costs over their lifetime than those at a healthy weight. The best way to know whether your insurance will cover the procedure is to call your insurance provider directly and discuss it with a representative. If your policy does not cover it, your surgeon can help you write an appeal letter that details why you should be covered. Doctors have a strong record of success in getting insurers to cover the operation. If you’re looking to have your insurance cover weight loss treatment, there are a few factors to consider.

Insurance

Insurance coverage is an important consideration, as the costs of bariatric surgery can be prohibitive for many patients. Most private insurance plans include the Roux-en-Y bypass, laparoscopic adjustable gastric banding, and sleeve gastrectomy as covered procedures for qualified candidates. Most insurers require that patients meet specific medical guidelines, such as a BMI of 40 or more or 35 and above with co-morbidities, and that they’ve failed attempts at conservative weight management through diet and exercise. The insurance company’s decision to deny payment for a procedure is often made based on a lack of medical necessity. A patient must prove that the treatment is necessary to treat a life-threatening condition. This process may involve a lengthy and thorough pre-approval process with documentation, letters from your physician and consultants attesting to the need for the treatment, and a variety of other paperwork and medical tests. There is a team of professionals who will work with you to obtain the required information and documents for pre-approval with your insurance company. They will also help you to appeal the denial if necessary. There are independent clinics that can work with you to find creative financing options to cover the surgery cost. Many patients opt to use health savings accounts or flexible spending accounts or take out a small loan to pay for the procedure.

Recovery

Bariatric surgery is a complex procedure that is not without risk. Patients must also commit to making significant lifestyle changes for success. Non-compliance with dietary and exercise guidelines may hinder weight loss, cause medical complications, and reduce quality of life. The most common operations for morbid obesity are biliopancreatic diversion, gastric bypass, and laparoscopic sleeve gastrectomy. The mechanisms of action of these surgeries involve restriction or malabsorption of ingested food, and they are typically associated with long-term weight loss and improvement in obesity-related co-morbidities. Recovery from bariatric surgery can vary depending on the type of operation and surgical site. Generally, most patients can return to work after several weeks. However, it is essential to communicate with managers and co-workers about the recovery process so that they can be flexible and understand why a patient’s energy levels will fluctuate. Most bariatric surgery patients must take medications to treat their chronic health conditions after surgery. These medications can usually be reduced or eliminated with the help of primary doctors and surgeons. Patients are also required to stop smoking because it negatively impacts their ability to heal after surgery, increasing the risks for lung infections like pneumonia and blood clots. Smokers also increase the likelihood of having a bowel obstruction, a problem that can be life-threatening.

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