Policies

Bariatric Patient Policy

Private Pay Bariatric Patients:
Payment for surgery is due at least fourteen (14) days prior to your surgery date. We accept cash, cashier’s checks (payable to KC Bariatric, LCC), and credit card payments ONLY. No personal checks will be accepted. If you have made financial arrangements through a medical loan company, the check should be made directly to KC Bariatric, LLC and received in our office at least fourteen (14) days prior to surgery. Included in the private pay price is one (1) year of office visits related to your bariatric surgery.

Insurance Bariatric Patients:
It is your responsibility to know what your deductible and co-insurance amounts are during the approval process at the time of surgery. Following insurance payment, all of the remaining balances are due within (30) days.

Prior to surgery, KC Bariatric’s billing office will contact you with your estimated amount due, this amount and any outstanding balances are due in full (14) days prior to surgery.

Medicare Bariatric Patients:
After Medicare pays 80% of the Medicare allowable rate, you will be responsible for the remaining 20%. The balance is due in full prior to surgery.

Financial Policy

In order to maintain vital health care services for our patients, it is necessary that you understand our credit and collection policies so that we might continue with this care.

• I authorize KC Bariatric and all associated providers to release my personal and confidential information to my health insurance carrier for the purpose of verifying my coverage, benefits, payment information and researching coverage criteria and/or requirements.
• Co-payments are due at the time of service. Your insurance policy is an agreement between you and your insurance company. After a 90-day global period following your surgery, you are required to pay your co-payment for all office visits and Lap-Band fills.

• Please note that one of our Nurse Practitioners may be consulted to see you in the hospital and post-operatively for medication management or management of other medical conditions. Most insurance carriers will pay for these visits, subject to your deductible and out-of-pocket.

• Medically Supervised Weight Loss appointments may be required for your Program but may not be covered by your insurance policy. If this is a covered benefit, you will be subject to the associated co-payment/co-insurance. If these services are a non-covered benefit, you will be responsible for a minimal fee to cover the services provided.
• After services are performed, you become responsible for the payment of the physician’s fees. Coverage for services and levels of payment by your insurance company depends on the terms of your contract with your insurance company. You are responsible for any amounts not covered by your insurance plan.
• For patients without insurance, payment is expected at the time of service.
• We accept cash, debit cards, Visa, MasterCard, American Express & Discover credit cards. We also accept personal checks (except for making payment toward non-insured private pay patient’s surgeon charges), but if the check is returned for insufficient funds, you will be responsible for bank penalty fees related to the transaction.
• A fee of $30.00 will be assessed for appointments missed without notification at least 24 hours prior to the visit.

Insured Patient Out-of-Pocket Cost Acknowledgment for Surgeon Charges

Your Case Manager at KC Bariatric, LLC has verified your insurance benefits DO include coverage for bariatric services. Once your surgical procedure has been authorized and performed, the insurance carrier will pay your claim based on their “allowable charge” (regardless of the actual amount we bill for the procedure). The out-of-pocket amount you may eventually owe will be determined based on the insurance carrier’s allowable charge for your procedure, the deductible amount you may still need to satisfy, the patient co-insurance percentage applied to the “allowable charge,” and whether you have exceeded your annual out-of-pocket cost limit.

You will be given a formal up-to-date estimate of your share of the surgeon’s charges, approximately one (1) week prior to your final pre-operative visit. We will expect the full payment of the charges at the time of your preop visit.

Please note: your share of the surgical facility charges will be billed to you separately by the surgical facility where your procedure is performed. Those charges are separate and in addition to the KC Bariatric, LLC surgeon’s fees.

HIPAA & Privacy Policy

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

 Our Commitment to Your Privacy

At KC Bariatric, we understand that medical information about you and your health is personal. We are committed to protecting your health information. This Notice describes how we may use and disclose your Protected Health Information (PHI) to carry out treatment, payment, or health care operations and for other purposes permitted or required by law. It also describes your rights and our obligations regarding the use and disclosure of your health information.

Our Legal Duties

We are required by law to:

• Maintain the privacy of your PHI.
• Provide you with this Notice of our legal duties and privacy practices.
• Abide by the terms of this Notice currently in effect.
• Notify you if a breach of your unsecured PHI occurs.

How We May Use and Disclose Your PHI

We may use and disclose your PHI for the following purposes without your written authorization:

1. Treatment

To provide, coordinate, or manage your health care and related services by healthcare providers.

2. Payment

To bill and collect payment for treatment and services provided to you.

3. Health Care Operations

For practice operations including quality assessment, employee review, training, licensing, and other essential business functions.

4. Appointment Reminders and Health-Related Benefits

We may contact you with appointment reminders or information about treatment alternatives or health-related benefits and services.

5. Business Associates

We may share your information with third-party service providers (business associates) who assist in treatment, payment, or operations, under written contracts requiring them to safeguard your information.

6. As Required by Law

We may disclose PHI when required by federal, state, or local law.

Special Situations

We may also use or disclose your PHI in the following circumstances, as permitted or required by law:

• Public Health Risks
• Health Oversight Activities
• Judicial and Administrative Proceedings
• Law Enforcement
• Coroners, Medical Examiners, and Funeral Directors
• Organ and Tissue Donation
• Research (under strict conditions)
• To Prevent Serious Threat to Health or Safety
• Workers’ Compensation
• Military and Veterans
• National Security and Intelligence Activities
• Correctional Institutions

Uses and Disclosures Requiring Your Authorization

We will obtain your written authorization for:

• Most uses and disclosures of psychotherapy notes (if applicable)
• Marketing purposes
• Sale of your PHI
• Any other uses and disclosures not described in this Notice

You may revoke your authorization in writing at any time.

Your Rights Regarding Your PHI

You have the following rights regarding the PHI we maintain about you:

1. Right to Inspect and Copy

You may request to inspect and copy your medical records, with some exceptions. A fee may apply.

2. Right to Amend

You may request that we amend your records if you believe they are incorrect or incomplete.

3. Right to an Accounting of Disclosures

You may request a list of certain disclosures we have made of your PHI in the past six years, excluding those for treatment, payment, and health care operations.

4. Right to Request Restrictions

You may ask us not to use or disclose certain parts of your PHI. While we are not required to agree, we will comply with a restriction if the disclosure is to a health plan for payment or operations purposes and the item was paid out-of-pocket in full.

5. Right to Request Confidential Communications

You may request that we communicate with you in a specific way (e.g., only at work or by mail).

6. Right to a Paper Copy of This Notice

You may request a paper copy of this Notice at any time.

Kansas State Law Considerations

Kansas law provides additional protections for certain types of health information, including but not limited to:

• Mental health records
• HIV/AIDS status and testing
• Genetic testing information We will comply with these additional protections as required by Kansas law.

Changes to This Notice

We reserve the right to change the terms of this Notice at any time. Any change will apply to all PHI we maintain. We will post a current copy in our office and on our website (if applicable). The effective date is listed at the top of this page.

Questions or Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

Privacy Officer
KC Bariatric
23401 Prairie Star Pkwy, Ste B300

Lenexa, KS 66227