Insurance Coverage 

It is important to note that insurance coverage associated with weight-loss surgery and treatments varies greatly between insurance companies. Before pursuing any type of professional weight-loss assistance, be sure to contact your insurance provider – not all carriers will cover weight-loss treatments and procedures. If your health insurance does not cover the costs of weight-loss treatments, you will be completely responsible for all of your weight-loss medical bills. To obtain financial information regarding the cost of surgical and non-surgical weight-loss options, call 314-344-6800.

Your insurance provider may require that you have prerequisite weight-loss treatments before allowing you to receive insurance coverage for surgery. For instance, some insurance companies require documentation of participation in a six-month physician-supervised weight-loss program, like HMR® (Health Management Resources), in the previous year before weight-loss surgery. Be sure to ask for all the details.

Until we receive insurance authorization, or payment arrangements have been finalized, we cannot schedule a procedure. Your insurance provider will notify both of us at the same time regarding your approval status. If you have questions regarding the progress of your request, please contact your insurance provider.  Note that the evaluation and insurance/payment verification process may take up to six months to complete.

Surgical Treatment
Billing Process
After you have received treatment at the SSM Weight-Loss Institute, we will bill your insurance provider. Your insurance provider will notify us after processing your claim and you might receive an “Explanation of Benefits” (EOB) from them which explains how your bill was processed and any fees not covered by your insurance. We will bill the guarantor the balance once the claim is processed by your insurance provider. We may also seek assistance from the policy subscriber if we fail to receive a response from your insurance provider.

Note: Not all charges may be included in your bill. Physician billing groups may invoice you separately. 

Managed Care Plans
If you are a member of a Managed Care Plan, your insurance provider may require that your Primary Care Physician (PCP), or plan provider, authorize any services. You may also be required to have a referral authorization in order to receive care and be responsible for a co-payment. Please contact your PCP, or plan provider with any questions. If you are admitted as an observation patient, we will process your bill as an outpatient visit in compliance with your managed care plan’s payment guidelines.

Self Pay
If you do not have health insurance, you will be billed directly for all services. If you cannot make payment, please contact our financial services department at 314-344-6272 for payment options.

Non-surgical:
HMR® is a fee for service program and does not accept any insurance plans.

Nutrition and Wellness Center Services:  Most insurance plans are accepted for nutrition services.  Please check with your insurance company to verify your coverage. Insurance does not cover a membership to the Wellness Center.