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Getting Started

How to get started

The process leading up to bariatric surgery varies depending on each person’s medical history and insurance requirements. Please review the process below for additional information.

How Do I Know if I Am a Candidate For Surgery?

At Cumberland Bariatric Institute, weight loss surgery is done only if a patient meets the following criteria:

  • A Body Mass Index (BMI) of 35 or more. BMI is a simple way to calculate the amount of fat on your body. 
  • The person has already tried non-surgical weight loss treatments such as diet, exercise, and behavioral changes.
  • The person has no medical or hormonal reason for the obesity. These conditions are rare but require treatment of the underlying medical problem.
  • The person must be fully informed about the surgery and have realistic expectations of weight loss and possible complications.
  • The person must demonstrate a willingness to accept the risks of surgery.
  • The person must demonstrate a willingness to make dramatic lifelong changes in lifestyle, dietary habits, and exercise and also commit to medical follow-up.

Appointment Scheduling

Once insurance review is complete a member of our staff will contact you to set up an appointment for an evaluation. When you attend a seminar at our weight loss clinic, you will have the opportunity to speak with any number of our Bariatric Staff, including the surgeon, dietitian, nurses, and insurance coordinator(s).

Evaluation

The evaluation appointment is scheduled for about two weeks after we call you. It’s a group meeting with a nurse, dietitian, surgeon and insurance specialist. You’ll also have a one-on-one meeting with the physician assistant for initial history and physical. After that visit, you will be scheduled for:

  • A nutrition assessment.
  • A psychological evaluation.
  • A weight loss program (if your health insurance requires this).
  • Additional medical tests, as determined by the surgeon.
  • You will need to attend a support group. People who have undergone bariatric surgery find it easier to make the necessary lifestyle adjustments when they have the opportunity to meet and talk with other people going through the same experience.
  • Your medical record will be reviewed. After all your tests are completed, you will learn whether the clinic’s surgeon/physician assistant has cleared you for surgery.
  • Your case is sent to your insurance carrier for approval.
  • After the insurance company approves the surgery, your pre-operative appointments and surgery will be scheduled.

 

Insurance & Financing

By using the Insurance Review Form in the Patient Profile Packet, you will know if your policy has benefits for weight loss surgery. If it does and you want to proceed, send in your Patient Profile Packet and the Insurance Review Form. We will screen your health history to make sure you are an appropriate candidate and our Insurance Team will make sure you meet the criteria set forth by your insurance policy. Assuming you meet all criteria, we will call to schedule your first appointment, where you will receive a personalized benefits form that will estimate, to the best of our abilities, your total out-of-pocket expenses. You will also need to complete a seminar, either in-person at our facility, or online.

Insurance FAQs

Most insurance plans require that your BMI be 35 or higher. However, if your BMI is between 30 – 35, we can sometimes get you approved if you have a life-threatening medical condition, such as high blood pressure, diabetes or sleep apnea.

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