11102020 Georgetown B

we learn about insurance coverage at GTBC

To news at noon everyone.

I'm troy thompson.

I'm over here at georgetown bariatrics and advanced surgical services.

It's their actually brand new location.

I want to introduce you to the man behind the brand, dr. eric smith,and of course one of his team members, jennifer, who is part of the insurance department.

Welcome to the show both of you.

Dr. eric smith: thanks.

Jennifer- insur...: thank you.

Troy- host: all right, so a lot of people ask on the street, especially if they get to see you and the people that want to be involved.

What are some of the most common questions your team get asked from someone interested in a surgical procedure?

Jennifer- insur...: how much is it and when can i have it?

Troy- host: yes,exactly.

I was going to say, they're probably the two most important questions,right?

Jennifer- insur...: mm-hmm , that's it.

Yes.

Dr. eric smith: right.

Troy- host: and,what is your response to that?

Jennifer- insur...: well,basically we let a potential patient know within minutes of receiving their application pretty much, how much it's going to cost and how long their process is going to be, because it is an insurance- based system.

Troy- host: well,this is something i want to ask you.

If i'm the patient at home and i goon line, how long before i get to see dr. smith and is dr. smith the one making the decision whether i qualify for the procedure?

Dr. smith?

Dr. eric smith: you know, i think the first thing we do is when they fill out an application or they do the seminar online and they submit.

Jennifer or someone from our office is going to reach out in a matter of days- troy- host: really?

Dr. eric smith: to confirm, do you have benefits through your insurance?

If you do, here's how much it will cost you out of pocket.

They know from day one.

If you don't, here are some options of how you could still have the surgery.

Once we get through that, then they're going to come in and see me, and we're going to make a determination if from a health standpoint or a medical standpoint they qualify for surgery, we think they're ready to proceed with surgery, and what their surgical options would be.

Troy- host: this is an important question, because not a lot of people have insurance, jennifer.what are their options?

Jennifer- insur...: well,people get creative.

They can use their 401k.

We have a wonderful finance group that we partner with called prosper lending.

They work with our patients one on one.

Sometimes people borrow money.

I mean, it's just however they can do that.

Troy- host: when someone is going online, doing the seminar, filling out their information online, and the insurance porthole, i would assume, that they put all their information in.

How long before they know that they qualify?

Jennifer- insur...: typically,we get those packets within three days.

Troy- host: really?

Jennifer- insur...: yeah.and so, within that time frame we're usually calling within three days,typically.

Troy- host: what's the next step after they know they've qualified?

Dr. eric smith: if they've qualified, then they come in for what we call an intake.

Troy- host: right.

And that's their initial visit.

When they would come in and they'd get a class with the dietician, they would meet me and i talk to them about diet and exercise.

We really don't talk a lot about surgery.

We talk about the steps to put in place to combine with surgery to be successful.

They're going to meet jennifer and our insurance coordinators, and talk about how many months does your insurance require for checking in for weights and things like that?

We'll set them up for their psychological evaluation, as well as get them set up for any type of clearances.

Cardiac clearances, pulmonary clearances.

All in one step.

They're going to meet us all on the first day.

Troy- host: so, do we know once we sign up and you've spoken to the insurance people, jennifer, what extra expenses would be incurred if insurance isn't covering it?

Jennifer- insur...: we basically set it up to where it's surgery focused because everyone is different.

You may have testing that i don't have to have.

Troy- host: oh, okay.

Jennifer- insur...: so, we keep it simple.

This is how much the surgery costs, anesthesia, a couple office visits, and that's our base price.

Troy- host: that's amazing.

All right, so no program fees.

What does that mean?

Dr. eric smith: many programs charge a fee just to come in.

They may say, "hey, we need $500 up front just to be evaluated."

Just to start the process.

We don't ever do that to patients.

I don't think that's the right way to do it.

If they don't qualify or we can't offer services to them, then they're nothing out of pocket.

Troy- host: well, we appreciate both of you coming in.

Thank you for all the information yet again.

Jennifer, nice to see you as well.

Jennifer- insur...: thank you.

Troy- host: if you want to find out more information about georgetown bariatrics and advanced surgical services at their brand new location, there it all is up on the screen for you.

We'll be back