Payment options and
Insurance
“Will
this be covered under my insurance?” is a common
question among patients considering surgery. Depending
on your plan benefits, many insurance carriers now
provide a benefit for weight loss surgery procedures.
Contact your insurance carrier to identify whether or
not you are on an HMO or PPO plan and what the level of
coverage the insurance carrier will cover. There is
also the option of paying cash. You as the patient are
responsible for following through on payment and/or
balance regardless of what your insurance covers or not.
HMO
vs. PPO
Regardless if you have an HMO or PPO plan, it is
important to know if your physician and hospital are
contracted with your insurance and if it will be
authorized. Typically PPO plans are more flexible.
HMO
Plans
Health
Maintenance Organizations (HMO) typically require for
the procedure to be completed within your network. A
referral must be made to the specialist and an
authorization approved for the surgery.
PPO
Preferred Provider Organizations (PPO) typically have
out-of network benefits that allow patients to select
their physician and hospital. If the physician selected
is not contracted with the insurance carrier, benefits
will be slightly reduced, depending on your plan, and
will be paid as out-of-network. This will result in the
patient being responsible for the balance and/or
deductible. If the physician and hospital are in-network
the benefits will be slightly increased, meaning the
insurance carrier to pick up more costs.
Cash
or Credit
The
advantage of cash or credit is that you do not have to
wait for an authorization. If this type of method works
for you, please let us know prior to billing.
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