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Working With Doctors and Insurance
Your health care team can be a source of support and assistance in gaining coverage for your weight loss surgery. Have the following information available when talking with your doctor about coverage:
- Insurance provider’s name and phone/fax number
- Policy number or employer’s plan number
- Insurance company patient representative and/or contact person
- Insurance company e-mail address
- Insurance company web site address (Many insurance providers maintain web sites that include member information, such as coverage of medical procedures. Sometimes providers may require you sign up to view certain areas of the web site. This process may be confusing. If so, call your provider and ask to be walked through the sign-up process.)
Here are some helpful tips to remember when you are speaking with your insurance representative:
- Speak slowly and clearly.
- Ask for their name and write it down when they answer the call (request they spell it for you if you are not sure).
- Ask for a specific phone number and/or e-mail address from the representative and write it down.
- Ask for a hardcopy of your policy or employer’s Summary Plan Description (SPD) to be mailed to you with the areas regarding obesity and severe/morbid obesity highlighted.
- Make sure you receive anything you are promised or guaranteed with your policy in writing.
- Keep a detailed record of all your documents.
- Be persistent.
- Do not demand anything.
- Do not threaten anyone.
- Do not get frustrated. If you experience an unpleasant representative, simply thank them for their time, hang up, and call back.
This content is adapted from The OAC (Obesity Action Coalition) Insurance Guide.