How to Get Started

The process leading up to bariatric surgery varies, depending on each persons medical history and insurance requirements.

The Surgery Process

If you decide gastric bypass surgery may be right for you, here is a basic overview of the surgery process:

  • Your evaluation appointment will be a group meeting with a nurse, dietitian, surgeon and insurance specialist. Youll also have a one-on-one meeting with the surgeon.
  • After that visit, you will be scheduled for:
    1. A nutrition assessment
    2. A psychological evaluation
    3. A weight management program (if your health insurance requires this)
    4. 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 clinics nurse practitioner has cleared you for surgery.
  • Your case will be sent to your insurance carrier for approval.
  • After the insurance company approves the surgery, your pre-operative appointments and surgery will be scheduled.

Insurance and Financing Options

Before you decide on weight loss surgery, you should contact your insurance carrier to verify:

  1. Whether weight loss surgery is covered by your policy.
  2. Whether Vanderbilt University Medical Center and the surgeons at the Vanderbilt Center for Surgical Weight Loss are part of your insurance coverage.
  3. The dollar amount for your deductible, co-insurance and/or out-of-pocket maximum.

When calling your insurance company, please use these codes for operative procedures:

  • Roux-en-Y gastric bypass: CPT 43644
  • Sleeve gastrectomy: CPT 43775

In the past, the insurance companies listed below have approved Vanderbilt patients for weight loss surgical procedures. Contact them directly to verify your coverage.

Anthem Blue Cross Blue Shield (BCBS)
BC Excellus
BC Wellmark
BCBS Alabama
BCBS Arizona
BCBS Arkansas
BCBS California
BCBS Florida
BCBS Georgia
BCBS Illinois
BCBS Indiana
BC Kansas City
BCBS Massachusetts
BCBS Michigan
BCBS Minnesota
BCBS Nebraska
BCBS North Carolina
BCBS New Jersey
BCBS Oklahoma
BCBS of Pennsylvania
BCBS Rochester New York
BCBS South Carolina|
BCBS Tennessee
BCBS Texas
BCBS Wisconsin
Capital BCBS
CareFirst BC
CareFirst BCBS
Center Care
Cigna - Great West
Definity Health
Empire BCBS
Excellus BCBS
Federal BCBS
First Health
Horizon BC
Horizon BCBS
Humana Medicare
Medicare Meritain Health
North America Administrators-PHCS
Premera BC
Regence BCBS
United Healthcare
United Healthcare Secure Horizon Medicare HMO
Windsor Medicare

Financing Options for Self-Pay Procedures
Wells Fargo