Program Checklist
At the Bridges Center, we are happy to help guide and support you throughout every stage of your weight loss journey. And to help get you started, the following is a checklist of general insurance and program guidelines required to undergo bariatric surgery. As always, please feel free to phone our office should you have any questions or if you need any additional information: Our toll free phone number is 1-800-248-5553, and our local phone number is 602-251-8828.
Step 1: Verify Your Benefits.Phone the member services number on your insurance card to verify if you have bariatric surgery coverage. The primary diagnosis code is 278.01 (morbid obesity) and the related surgery codes are listed below:
43644 – Gastric Bypass
43770 – Adjustable Gastric Banding
43775 – Vertical Sleeve Gastrectomy (VSG)
43845 – Biliopancreatic Diversion with Duodenal Switch
43860 – Revision
Step 2: Bring a Referral. If your insurance requires a referral or authorization to see a specialist, please make the appropriate arrangements with your primary care physician. Please verify that the bariatric surgeon’s office has received your referral prior to your appointment.
Step 3: Attend a Bridges Center Weight Loss Group Seminar. Register and attend one free weight loss group seminar at the Bridges Center in Phoenix or Tempe (click here to register now). At the seminar, you will receive a Confirmation of Attendance certificate. This certificate enables you to schedule your one-on-one consultation with a Bridges Center board-certified bariatric surgeon of your choice. You will need to bring your certificate to your one-on-one consultation meeting.
Step 4: Attend a One-On-One Meeting with Your Surgeon. To schedule your consultation, please phone your surgeon’s office directly (phone numbers provided below). If you have not yet chosen a bariatric surgeon, visit our Board-certified Bariatric Surgeon web page.
Daniel T. Fang, M.D., F.A.C.S., and Hilario Juarez, M.D., F.A.C.S.
Abdominal Surgeons LTD at St. Luke’s Medical Center
Phone: 602-252-1510
Eric Schlesinger, M.D., F.A.C.S., and Kurt W. Sprunger, M.D., F.A.C.S.
Surgical Weight Loss Solutions at Tempe St. Luke’s
Phone: 480-968-6007
Before attending your one-on-one consultation with your surgeon, please provide the required health history information. Your health history information must be received by the surgeon’s office in time for your consult appointment. To submit your health history online, please select from the following:
- For surgeries at St. Luke’s Medical Center, click here
- For surgeries at Tempe St. Luke’s Hospital, click here.
Following your one-on-one consultation, your surgeon’s office will submit the request for surgery to your insurance company, and will contact you once approval has been granted (please note, this process can take between four and six weeks). Remember, your seminar Certificate of Attendance must be submitted to the surgeon’s office at your consult appointment. Your surgery will not be scheduled without this proof of attendance.
Step 5. Provide Medical Records and Supporting Information: Please see below for a standard list of requirements. Please note that requirements vary based on insurance company and surgeon requests. Standard requirements for all patients include:
- Letter of medical necessity from primary care physician
- Psychological evaluation (including MMPI)
- Documentation of previous weight loss attempts
- Cardiac clearance (patients over 50 and as determined by insurance company or surgeon)
- Pulmonary clearance (patients over 50 with a BMI over 50, and as determined by insurance company
or surgeon)
Some insurance companies may require the following information:
- Medical records documenting weight history for a period of one to five years depending on
health plan
- Dietary consult
- Medically supervised diet and exercise program:
• 3-, 6- or 12-month diet requirement
• Must be consecutive and completed within the last two years
- Miscellaneous labs (i.e. – TSH, H. Pylori, drug and alcohol screening, A1C, tobacco use, etc.)
Additional information and/or testing may also be requested by the surgeon.
Step 6. Attend Bridges Center Educational Bariatric Classes. After the consult appointment, all patients must attend one introduction class related to the surgery they will receive. After a surgery authorization is received, patients will attend a preoperative class approximately two weeks prior to scheduled surgery. Both education classes are required and are designed to provide patients with the tools and information they need to experience success in their weight loss journey. |