Qualifying for weight loss surgery in Nashville, Tennessee

Diet and exercise may not be enough to reach your weight loss goals. If so, a bariatric surgeon at one of TriStar Health's hospitals in Middle Tennessee can help you determine if surgery is an option for you. They will review your eligibility for bariatric surgery as well as the pros and cons of each procedure.

For more information about our weight management clinic, please call (833) 296-8051.

We determine eligibility for bariatric surgery on an individual basis. In general, to undergo weight loss surgery, patients must:

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Body Mass Index (BMI) is a number calculated from a person's weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.

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Disclaimer:
All information provided by this website is intended to be general in nature and should not be used as a substitute for a visit with a health care professional. No information provided in this site may be considered medical advice. The information may not be relevant for your individual situation and may be misinterpreted. HCA assumes no responsibility for how you use information obtained from this site. Before making any decisions regarding your health care, ask your personal physician.

Eligibility for specific bariatric procedures

In addition to the above prerequisites, specific surgeries have other requirements you must meet.

Eligibility for vertical sleeve gastrectomy

Vertical sleeve gastrectomy, gastric bypass and duodenal switch can be a good option for people who are either extremely overweight or whose medical condition rules out other types of surgery, like joint replacement, hernia, spine and cardiovascular surgery.

For people who are extremely overweight, vertical sleeve gastrectomy is normally performed in two parts. The second surgery is only planned once the patient’s weight has decreased enough to lower their surgical risk.

Eligibility for gastric balloon

Gastric balloon may be a weight loss option for adults with a BMI between 30 and 40. Before moving forward with surgery, patients may be asked to complete supervised weight loss plans, including diet, exercise and behavior modification programs.

If these efforts do not achieve maintainable weight loss, patients will be further evaluated for surgery. This will include things such as:

  • A physical evaluation
  • Checking for internal factors, such as stomach irritation or ulcers, which may interfere with surgery

Eligibility for revision surgery

Revision surgery may be needed for many reasons. For example, a procedure may not achieve the desired weight loss, or it may cause adverse effects. However, eligibility for the procedure largely depends on the patient's diet and lifestyle habits after surgery, in addition to insurance requirements.

For example, a patient may need gastric sleeve revision surgery if they are optimizing the usage of the sleeve as a tool but are experiencing weight gain or insufficient loss. Patients experiencing this because of factors such as swelling or the newness of the surgery (rather than reverting to poor eating habits) may be eligible for revision surgery.

Bariatric surgery insurance eligibility

The bariatric surgery insurance approval process can be challenging. Our dedicated insurance specialists help you successfully navigate the approval process. We will:

  • Verify your insurance benefits and criteria specific to your plan
  • Provide the estimated out of pocket amount based on your insurance coverage
  • Obtain medical records, referral letters and any other documentation required by your insurance
  • Work with your insurance company to obtain approval for surgery
  • Keep you informed and updated every step of the way

Our surgeons and medical center are in-network providers for most insurance plans. Criteria for bariatric (weight loss) surgery insurance can vary greatly by plan and by employer.

Self-pay options are also available.