What do You do Now?

If you feel that weight loss surgery may be an option for you, there are several steps that you need to take. First, discuss the idea with your primary care provider or personal physician and with your mental health care provider if you have one. If you are in need of a referral for a primary care physician or mental health professional, our team will be pleased to assist you by connecting you to our Department of Family Medicine .

Next, you will need to query your insurance company if obesity surgery is covered by your plan. If you have an HMO or a PPO type of health plan, determine the procedure for obtaining a referral for the Bariatric surgery services provided at University of Illinois Medical Center. If you have no health insurance, or if your health plan will not cover the cost of weight loss surgery, you may still elect to have the surgery at University of Illinois Medical Center on a cash paying basis.

Insurance Policies

After it has been determined that you are a candidate for Bariatric surgery, the insurance authorization process begins. First, a letter of medical necessity is forwarded to your Primary Care Physician (for HMO or POS patients) or directly to your insurance company (in the case of PPO insurance). A copy of this letter will be mailed to you directly as well. Once the PCP or insurance receives this predetermination request, they will determine if your particular policy covers this type of surgery and if you meet the insurance company criteria for this type of surgery. Once this predetermination has been granted, a surgery date will be assigned. In addition, you will also be scheduled for pre-op testing, the final pre-op surgical visit with your surgeon, and a pre-op anesthesia evaluation.

Finally, your pre-certification will be called to your insurance company once a surgical date has been set. This process varies from insurance company to insurance company. Once you have obtained the letter from the Division of General Surgery that your predetermination letter has been sent, you as the patient should contact the insurance company to check on the status. Please DO NOT contact our office regarding the status of your insurance predetermination request. If our office does obtain the approval, we will contact you as soon as we receive it.