When does insurance cover revision surgery?

Does Insurance Cover Revision Surgery?

The number of people undergoing weight loss surgery has been on the rise. While some surgeries have been successful, there have been instances when a revision is necessary.  In this case, revision is defined as a change or modification of previous surgery.  The revision can be as a result of a failed bariatric procedure or revision to a new procedure.

When does insurance cover revision surgery?

The question of whether your insurance provider will cover your revision surgery is not an easy one to respond to.  Any request for a revision necessitated by a previous bariatric surgery that failed will cause the insurance provider to question whether the surgery failed or the patient failed to follow all the post-surgical requirements.

Any type of weight loss surgery requires the patient to commit to making lifestyle changes if they want to be successful in achieving their weight loss goals. The patient will need to make changes in their diet and become more aware of the nutrients and calories in the foods they consume. This can be difficult for most patients especially when their psychological needs have not been attended to. The patient could also be struggling financially and is therefore unable to purchase the correct foods.

What Does Insurance Want To Know?

Since the insurance company will want to know why you need a revision, you should be able to answer their questions satisfactorily. Your surgeon must be aware of your need for a revision and any issues related to the original procedure.  This is the information that you should provide to your insurance provider as you request authorization for a revision.

Any claims of a stretched pouch or failed staple line or slipped band, or a bypass that’s not working as it should be proven by undergoing pre-op testing.  You can get an MRI, CT scan, or Endoscopy done so that you can get the results to present to the insurance provider.  In addition, you should provide your surgeon with all the information regarding lifestyle changes made post-surgery as evidence of compliance.

It’s also important that you let your insurer know that the failure to grant you a revision could lead to an increase in your BMI. This increase can lead to a return of obesity-related health conditions such as diabetes, sleep apnea, and hypertension.  Should your request involve a new type of surgery or one that was not available when you had your surgery done, ensure that you include all the required information in your request.

Your insurance provider will only pay for a revision when you provide them with all the relevant information.

Weight Loss Surgery in Arizona

Are you looking for gastric bypass in Phoenix? The Weight Loss Institute of Arizona can help. Our surgeons have over 10 years of surgery experience and have been able to make a name for themselves in the Phoenix metro area. Schedule a consultation with us today!

The Myths Surrounding Obesity & Bariatric Surgery

The myths and misconceptions that exist about obesity and bariatric surgery that make it impossible for individuals to pursue a healthier lifestyle.  Bariatric surgery in Arizona has proven to be beneficial in helping patients lose weight and reverse obesity-related health conditions.  Below are some myths and misconceptions about obesity and bariatric surgery.

Myths about Obesity & Bariatric Surgery

Common Myths about Obesity & Weight Loss Surgery

Myth: Bariatric surgery is a quick and easy solution to rapid weight loss for an obese person

Bariatric surgery is designed to help individuals who are severely obese achieve their weight loss goals.  The surgery alone is not enough; the individual must commit to making lifestyle changes such as dieting and exercising to prevent weight gain post-surgery.

Myth: People who are severely obese are lazy, and got there because of their laziness and lack of willingness to change.

People who are severely obese suffer from obesity and in most cases; they have tried to lose weight with little to no success.  Bariatric surgery is the only other option left for them should they wish to become healthier.

Myth: Weight loss achieved by bariatric surgery will fix all your obesity-related health issues

Obesity-related health conditions such as type 2 diabetes and hypertension can be reversed through weight loss thereby improving your overall health.  Rapid weight loss can cause health issues such as loss of muscle and low metabolism.

Myth: Insurance does not pay for bariatric surgery

Many insurance providers pay for weight loss surgery even though the coverage varies from state to state. Many plans will cover morbid obesity especially when it poses health risks to the patient. Find out from your insurer if they cover the surgery and what costs are excluded.

Myth: Some bariatric surgeries prevent proper nutrition

Some bariatric surgeries indeed have an impact on how your body absorbs some nutrients and you will therefore have to take supplements.  When you follow the nutritional guidelines given by your doctor, you should not worry about not getting enough nutrients.

Myth: Bariatric surgery is dangerous

All forms of surgeries have risks associated with them and bariatric surgery is no exception.   There have been a number of advances that have helped minimize the risks. Weight loss surgery Tucson are well trained and experienced.  Having weight loss surgery will also help you reverse life-threatening conditions linked to obesity.

Myth: All types of bariatric surgeries involve the reduction of stomach size

There are a variety of weight-loss surgeries some of which involve the reduction of stomach size and others involve the creation of a bypass in the digestive tract, all of which affect the way nutrients and calories are absorbed.

Guide to Finding the Right Bariatric Surgeon

Bariatric surgery is also known as weight loss surgery has proven to be beneficial in helping individuals lose weight and manage obesity-related conditions such as diabetes, sleep apnea, hypertension, and fatty liver disease among others. Once you have decided to have the surgery, choosing a healthcare facility and surgeon can be challenging. Below are factors you should consider before making the decision.

How Do I Choose a Bariatric Surgeon and Center?

Choosing a healthcare facility

There are several considerations you need to make before choosing a facility where the surgery will be conducted such as:

  • Bariatric center credentials: Choose a center that is accredited and where you will receive excellent care that is safer and more effective from a surgeon who is board certified.  The center should also have a history of having conducted successful surgeries. Before being accredited, the center must pass a thorough site inspection, its entire staff will be interviewed and its documents will be reviewed to determine if they meet the set standards.
  • Available care and support: bariatric surgery is not a one-time thing.  Choose a center that provides comprehensive care since what happens after the surgery has an impact on your ability to achieve your weight loss goals. The center should have nutritionists, psychologists, pulmonologists, cardiologists, and other medical specialists trained in bariatric care.
  • Availability of patient education: While the success of any bariatric procedure is dependent on the skills and experience of the attending medical team, patient education also plays a key role.  The center should provide you with pre-surgical and post-surgical education to prepare you for what to expect.

Choosing a surgeon 

The role of carrying out the surgery should be left to trained bariatric surgeons to minimize complications even though a general surgeon can still do the job.  Make the following considerations when choosing a surgeon:

  • Training and experience: choose a surgeon who specializes in bariatric surgery and is board certified.  When you’re operated on by bariatric specialist phoenix, your success rates go up.  A high-quality surgeon will also be willing to answer all your questions about the surgery.
  • Insurance coverage:  Select a surgeon who is part of your insurance providers’ network so that the cost can be covered by your provider.
  • Teamwork: Find out if your surgeon will work alone or with a team. Availability of a team means that you will be able to receive round-the-clock care.

If you need bariatric surgery in Arizona, consider giving us a call. Our surgeons work in a team as part of our commitment to provide the best care.

Find the Right Bariatric Surgery Procedure

After deciding to undergo bariatric surgery, it’s important to know that while all surgeries help you lose weight, not all of them are the same. Finding the right procedure will require you to have a sit-down with your bariatric surgeon who will evaluate your medical conditions, history, and expectations.  Below is a discussion of the various types of surgeries to help you decide the best weight loss surgery for you.

Gastric bypass surgery

When you undergo a gastric bypass or any gastric surgery in Arizona, the surgeon will divide your stomach into two parts. The upper section will be sealed and the lower section is directly connected to the small intestine thereby bypassing a larger section of the stomach.

Pros: it leads to raid weight loss that continues two years post-surgery and helps improve obesity-related conditions such as diabetes.  It’s also ideal for people with severe reflux disease and a higher BMI.

Cons: Since your body is not absorbing food as it used to, you’re at risk of not getting enough nutrients.  You should therefore follow a strict diet and take all your supplements.

Sleeve gastrectomy surgery (gastric sleeve)

When you undergo gastric sleeve Arizona, the surgeon will remove a large section of your stomach making it smaller.

Pros: It is much safer as it has a lower risk rate. It’s ideal for individuals who have had multiple abdominal surgeries before, people who are extremely overweight, and those who are receiving treatment for psychiatric illnesses.

Cons: it’s much harder to revise into another type of surgery such as duodenal switch, in case of inadequate weight loss. It also cannot be revised into a gastric bypass very easily.

Duodenal switch

When conducting a duodenal switch at bariatric surgery Phoenix, the surgeon will cut out a portion of your stomach to form a sleeve and then do gastric bypass surgery. This provides the patients with an opportunity to lose more weight. This is a high-risk surgery that should only be done by an experienced surgeon at an accredited center.

Pros: it helps one lose more weight compared to the other types of bariatric surgery.  It’s ideal for people with severe obesity, severe metabolic disease, and those who are good at following the doctor’s orders.

Cons: The malabsorption caused by the surgery makes malnutrition a very real possibility. Make sure to take your multivitamins and get enough protein.

Adjustable Gastric Band

The surgeon will use an inflatable band to divide the stomach into two sections that are still connected.  The upper pouch will empty slowly into the lower pouch.

Pros: It’s very simple and much safer compared to other bariatric surgeries. It also has a shorter recovery time and can be reversed.

Cons: The weight loss is very minimal compared to other forms of bariatric surgeries and it’s also possible to regain the weight lost. You can develop complications when the band becomes loose, slips out of place, or leaks.

Link Between Obesity & Infertility

There has been an increase in the number of people who are overweight making obesity an epidemic. Obesity has negative effects on all systems including the reproductive system. You are considered to be overweight if you have a BMI of between 25 to 29 and obese if your BMI is above 30. Being overweight affects the fertility of both women and men thereby affecting their ability to have children.

Hoe Excess Weight Can Cause Infertility?

How excess weight causes infertility in women

The menstrual cycle of a woman is regulated by a fine hormonal balance. Women who are overweight or obese have high levels of the hormone leptin. This hormone is produced in the fatty tissue and has the ability to interfere with the hormonal balance hence affecting the menstrual cycle. A woman with a hormonal imbalance issue will have a problem getting pregnant.

Obesity is also closely linked to polycystic ovary syndrome (PCOS) which occurs as a result of hormonal imbalance which creates a problem in the ovaries. It can lead to missed or irregular periods or the development of cysts in the ovaries. All of which cause infertility.

Excess abdominal fat also leads to insulin resistance which leads to reduced levels of the sex hormone-binding globulin which regulates androgen and estrogen.

Any interference with the hormonal imbalance also increases the risk of no ovary being produced which means the lady cannot get pregnant.

Excess weight also affects how fertility treatments such as in-vitro fertilization (IVF), ovulation induction, and intracytoplasmic sperm injection (ICSI) work.

How excess weight causes infertility in men

Excess weight in men is linked to changes in their testosterone levels and other hormones which are important for reproduction.  Low testosterone levels lead to erectile problems and sexual dysfunction.

Obesity can also lead to raised temperatures around the scrotum which can kill the sperms making the man infertile.

Excess weight can also lead to hormonal imbalance when the body has high levels of estrogen and low levels of sperm-producing hormones.  This means that the man will have a low sperm count or sperms that cannot swim well.  The physical and molecular structure of the sperm cells is also interfered with.

Conclusion

Medical weight loss interventions, especially those that are combined with diet and exercise have been shown to have a positive impact on fertility. You may want to talk to your bariatric specialist in Phoenix about weight loss surgery which can help address any fertility issues that are linked to excess weight. Contact the Weight Loss Institute of Arizona to learn more about medical weight loss in AZ!

Our Locations

Weight Loss Institute of Arizona, Tempe, AZ
Phone : (602) 325-9759
Address: 1855 E. Southern Ave., Tempe, AZ 85282

Weight Loss Institute of Arizona, Glendale, AZ
Phone : (602) 325-9760
Address: 16222 N. 59th Ave., Building D, Suite180, Glendale, AZ 85306

Weight Loss Institute of Arizona, Mesa, AZ
Phone : (602) 325-9761
Address: 4860 E. Baseline Rd., #105, Mesa, AZ 85206

Weight Loss Institute of Arizona, Tucson, AZ
Phone : (520) 979-3152
Address: 6261 N. La Cholla Blvd., #201, Tucson, AZ 85741

Weight Loss Institute of Arizona, Phoenix, AZ
Phone : (480) 696-5748
Address: 9305 W. Thomas Rd, Suite 480, Phoenix, AZ 85037

Weight Loss Institute of Arizona, Tempe, AZ
Phone : (602) 910-5428
Address: 1847 E. Southern Ave., Tempe, AZ 85282

Tempe St. Lukes
Phone: (480) 887-8193
1500 S Mill Ave, Tempe, AZ 85281