Do you have your ‘Golden Ticket’?
What is your Golden Ticket? It is the brightly colored gold/yellow piece of paper that Surgical Weight Loss patients receive when they check out after their consultation with the doctor; each patient receives one on this day. We call this the Golden Ticket because our office has marked what you need to do before we can submit your information to insurance to get your approval for weight loss surgery. You will want to hang on to this wonderful Golden Ticket so you can keep track of what all you need to get done before we can get you submitted. Put this on your fridge or bathroom mirror where you will see it everyday as a reminder of things that you need to do.
On the Golden Ticket is a check list of things that surgical weight loss patients need to be done. All patient’s must have a primary care physician (aka: pcp) letter of recommendation/clearance, a psychological clearance letter from a psychologist or psychiatrist, and attend a support group meeting before scheduling your surgery.
Some patients will need to do some additional things for insurance or surgeon requirements. These can include a cardiac clearance, pulmonology clearance, doing a sleep study, doing a consecutive monthly medically supervised diet visits with a doctor (aka: msd visits), and an x-ray of the upper GI. Some insurance plans require a 3 month medically supervised diet plan and others can require up to 12 months of medically supervised diet visits. Each insurance company and plan requires different things and your insurance will require all or some of these to give the approval.
The bottom of your Golden Ticket talks about finances. The doctor’s coordinator will mark the amount of money that we will collect from you when we schedule your surgery. In order to schedule your surgery this amount must be paid or have a payment plan set up with our office. Whether you are a pre-pay patient or are going through insurance we will be collecting some amount from you at the time you schedule.
There may additional costs involved before and/or after your claims are paid by the insurance. Also the hospital may have additional amounts you need to pay but that’s another BlOG.
Having this “Golden Ticket” at your fingertips will help you communicate more efficiently with the pre-determination coordinators as you work together to obtain records needed to send to the insurance companies. Do not forget to sign-up for our patient portal, this is a great way to communicate with our office for non-emergency questions.