5 Ways to Save Money & Time Choosing Your Bariatric Surgeon

October 14, 2024

There’s a lot of information to find out when you consider Metabolic and Bariatric Surgery (MBS). It can be so confusing and downright scary. How much is this going to cost? Who’s paying for what? Who’s the best when choosing your bariatric surgeon? What types of services should be included? It’s so important to know up front what you can expect and what’s expected of you. Services and fees vary, so you want to do your homework to prevent any surprises and unexpected costs.

These five tips will help you make the best surgeon and team selection for your situation:

If you do, find out if your insurance company has any specific requirements that your surgeon, hospital, or surgical center must meet. Your bariatric program will probably check to verify whether you have coverage for bariatric surgery. It’s also very smart to ask what your out-of-pocket fee is going to be. No matter how much the surgery costs, if the provider and the surgery facility are in network, they’ve agreed to accept the insurance company’s reimbursement cost. Your insurance company can then use that information to help you estimate your costs based on your copay, your deductible, your out-of-pocket maximum, and your coinsurance, maybe 80/20, 60/40, or 90/10.

Smart strategy: also call your insurance company yourself

After all, it’s your money. Sometimes the insurance company does not give the surgical center the correct information.

Ask these four questions:

1. Do I have coverage for bariatric surgery?
2. Are there any exclusions? Sometimes the policy itself covers bariatric surgery, but your employer who chose that policy has opted not to include bariatric surgery in YOUR policy. The representative might not check that critical detail, unless you ask.
3. Are there any facility limitations? Sometimes an insurance company may require that you go to a certain surgery facility. The insurance company might have a variety of reasons to require that, but a bottom-line reason is that it saves them money.
4. Ask if the provider and the facility (whether hospital or outpatient surgery center) are in your network.

More and more insurance policies do cover nutrition services. Verify that your provider is in network. You might also ask about copays per visit.

If you know you don’t have nutrition coverage, you may save money by asking the clinic for a cash price. If you pay at the time of your nutrition consultations instead of being billed for each one, it could save you money. Find out if your insurance or surgical center requires nutritional consultations and how many.

Ask around for surgeon referrals. Have friends or family had surgery? Who was their surgeon? Were they happy with the results? If you have insurance, find out which surgeons participate in your insurance plan so you pay the least out of pocket, and then cross-check to see if they are on your referral list as well.

Is the surgeon board-certified in bariatric surgery? This certification tells you the doctor has the skill, training, and knowledge necessary to provide you with the best surgical care.

Ask about MBSAQIP, which stands for Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Find out if the surgeon, hospital, or surgical center participates in this program. This program was established by the American Society for Metabolic and Bariatric Surgery (ASMBS) and the American College of Surgeons (ACS). MBSAQIP accredits inpatient and outpatient bariatric surgery centers in the U.S. and Canada that have undergone an independent, voluntary, and rigorous peer evaluation in accordance with nationally recognized bariatric surgical standards.

How many bariatric surgeries does the surgeon do a year? Look to see if the surgeon has the credential FASMBS, which stands for Fellow of the American Society for Metabolic and Bariatric Surgery. This designation means the surgeon does at least 25 ASMBS-approved surgeries a year.

You might not think about this, but does gender matter to you? Do you prefer a male or female surgeon? You may want to ask how many surgeries the surgeon has done on your gender so you get a good idea of their experience. How does the surgeon communicate with you as well as the surgical center team? You want a surgeon who hears you, considers your treatment preferences, and respects your decisions.

In addition to the surgeon, look for a comprehensive program that may include bariatric dietitians, behavioral therapists, medical specialists, and support groups. How often can you see them for help, and for how long after surgery?

Metabolic and bariatric surgery is a big decision. Take the time to do your homework, and be sure you find the right surgeon and team to meet your needs.

Bariatric dietitian Dr. Susan Mitchell is host of the podcast Bariatric Surgery Success. 

ABOUT THE AUTHOR Bariatric dietitian Dr. Susan Mitchell is host of the podcast Bariatric Surgery Success. Selected as one of the Best 35 Dietitian Podcasts, Bariatric Surgery Success was chosen from thousands of podcasts on the web ranked by traffic, social media followers, domain authority & freshness. With a focus on nutrition before and after bariatric surgery, I help you eat for success while you conquer cravings, emotional eating and weight regain. Read more articles by Susan!

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