Insurance Information

Dr. Clarey and Dr. Bruce accept most insurances. Below is a list of participating insurances plans: 

 The following insurance companies are accepted by our office for Gastric Bypass surgery. Some insurance companies have specific requirements. We will tell you, in advance, what information is needed for you to have for your appointment, however, having benefits for bariatric surgery does not mean that you are approved for the surgery. Please contact Member Services, on the back of your insurance card, for specific required information and testing you may need for Gastric Bypass surgery.

Any patient requesting to have a Laparoscopic Roux en Y or Lap Band will need to have a nutritional consult regardless of their insurance.

The number one reason for a delay in insurance approval is that we are not receiving the Medical Records from the patient's primary care physician (and/or other specialist) in a timely manner. For a copy of the Medical Records Release Form click on the link below, print it, and take it to your doctor . Have the doctor's office mail or fax your medical records to our office or, bring your records with you to your first appointment.

Medical Records Release Form

Aetna

• 5 years of medical records with a documented weight for each of those years
• Documentation of a prior 6 month supervised weight loss program or documentation of a 3 month program completed prior to surgery.

Anthem / BCBS

• Contact customer service to verify if bariatric surgery is a covered benefit under your specific policy.

• All Anthem and BCBS policies have different requirements regarding amount of medical records needed and if supervised weight loss documentation is required…please contact our office.

Caresource

• Documentation of a 9 month "physician supervised" weight loss program and documentation  of at least 1 co-morbid condition that is poorly controlled with medical treatment.

Choice Care

Cigna

• Contact customer service to verify if bariatric surgery is a covered benefit under your specific policy.
• Documentation of 6 month supervised weight program required.

Great West

• Contact customer service to verify if bariatric surgery is a covered benefit under your specific policy.

Humana

• Contact customer service to verify if bariatric surgery is a covered benefit under your specific policy.
• Documentation of 6 month supervised weight program required.

Medicaid

• Must have a BMI of at least 50 or, a BMI above 40 with documented life threatening hypertension or other cardiovascular disease. Life threatening diabetes, back surgery being refused by a surgeon due to obesity, or Pseudotumor Cerebri diagnosed by a neurologist and documented prior weight loss attempts.

Medical Mutual of Ohio and Supermed Plus

• Requires 6 months weight loss program documentation

Medicare

• Pays 80% and is automatically covered without sending record information, as long as you have a major co-morbid condition (diabetes, sleep apnea, hypertension plus a BMI of 35 or more).

Ohio Health Choice Plan

Secure Horizons

• Secure Horizons is now paying for the surgery.Contact customer service to verify if bariatric surgery is a covered benefit under your specific policy.

Tricare

•  TRICARE has updated their requirements (including 6 month diet and additional testing). Contact our office for a list.

United Health Care

• 5 years of medical records with a documented weight for each of those years.

Since Dr. Clarey and Dr. Bruce participate in many other insurance plans, please check your individual physician book for provider information for Alison A. Clarey, D.O. Inc. or call 937-439-4145 or toll free 877-298-0200.

Other forms of payment include:

• MasterCard or VISA   

• Cash

Please contact the office if you're interested in the cash pay option for Gastric Bypass or Lap Band. 

When paying cash:

The surgeon's fee must be paid by credit card, Cashier's Check or Money Order.  

Sorry, no personal checks. 

The fee must be paid at our Main Office at 2717 Miamisburg-Centerville Road, Suite 215, Dayton, Ohio 45459 and must be paid in full, in one payment, no later than 10 business days prior to your surgery date. 

There are no payment plans.

SELF-PAY INSTRUCTIONS

FOR GASTRIC BYPASS SURGERY

Our practice offers the self-pay option to patients that may not have an insurance carrier that covers the gastric bypass procedure.  This option is offered with the understanding that the patient knows ALL charges for procedures for this surgery are to be paid by the patient, including any charges incurred after surgery.  We offer this self-pay option at a SUBSTANTIAL DISCOUNT.   Self-paying patients are to be treated as any patient interested in the gastric bypass procedure.  Any requirements that must be met for the gastric bypass procedure apply to ALL patients, whether insured or self-paying.  Any requirements for pre-admission testing, psychiatric evaluations, etc., are necessary to assure that you may not incur any additional problems after surgery.     

The hospital fee for Grandview Hospital or Southview Hospital must be paid at the hospital financial office. You must contact Carol, the Financial Manager, prior to going to the hospital for payment at 937-463-4055. She will set up a time for you to come into the hospital with your payment.

You may contact the Grandview / Southview Anesthesia Billing Office at 937-226-7863 to make a payment. 

******** PLEASE NOTE ********

There are miscellaneous bills, such as Radiology, Pathology and Cardiology bills that will be mailed to you after your surgery. We are unable to inform you of these costs as they are based on the type of testing you may have.

All payments must be made no later than 10 business days prior to your surgery date, or your surgery will be cancelled.

We do not have any payment plans or billing arrangements.

It is the patient's responsibility to assure that all payments are made prior to the surgery date.