Insurance Committee

Michael Cook, MD FACS FASMBS
Chair

Maria Iliakova, MD
Co-Chair

Don Selzer, MD
Co-Chair

Helmuth Billy, MD
Board of Directors Liaison

Members

Matthew Brengman, MD FASMBS, Senior Past Chair
Yijun Chen, MD
Christopher Crawford, MD FACS FASMBS
Francesca Dimou, MD FACS MS
Adrian Dobrowolsky, MD FACS
Philip Gachassin, MD MHCM FACS FASMBS (Access to Care Committee Co-Chair)
L. Renee Hilton-Rowe, MD (Access to Care Committee Chair)
Crystal Johnson-Mann, MD MPH FACS FASMBS (Diversity & Inclusion Committee Liaison)
Tanya Kajese, MD FACS FASMBS (Access to Care Committee Co-Chair)
Wael Khreiss, MD
Jason Krynicki
Peter LePort, MD FASMBS
Walter Lindstrom, JD
Sheetal Nijhawan, MD FACS
Jaime Ponce, MD FASMBS
Jessica Sanchez, Financial Manager Program Coordinator
Marc Sarran, MD
Shireesh Saurabh, MD FACS DABOM FASMBS
Michelle Scerbo, MD MS
John D. Scott, MD FACS DABOM FASMBS
Hany Takla, MD FACS FASMBS
John Tann, MD FASMBS
Darren Tishler, MD FACS FASMBS (Access to Care Co-Chair)

Ad Hoc

Chris Gallagher, Washington, D.C.

ASMBS Staff Liaison

Leslie Vinson

Charge

In alignment with the American Society for Metabolic and Bariatric Surgery (ASMBS) mission to elevate global health and quality of life by significantly reducing the impact of obesity and its related illnesses, the Insurance Committee is tasked with bridging the gap between the details of insurance coverage and coding and the practicing surgeons and integrated health ASMBS members. The committee focuses on educating ASMBS members in insurance coverage, coding, and access, and serves as a liaison between the ASMBS, insurers, and CMS on coverage specifics for bariatric procedures. Lastly, the committee collaborates with the ASMBS Access to Care Committees on acute and chronic insurance-related access to care issues.

Description

The Insurance Committee plays a vital role in ensuring access to high-quality prevention and treatment of obesity by advocating for healthcare policies that enhance patient access. Through education, advocacy, and collaboration, the committee strives to empower healthcare providers with the knowledge and resources necessary to navigate insurance complexities and optimize reimbursement for metabolic and bariatric surgery.

Objectives

  • Advocate for appropriate reimbursement for metabolic bariatric surgery to incentivize healthcare providers to offer metabolic bariatric surgery, thereby expanding patient access to life-saving treatments.
  • Ensure appropriate CPT coding for securing appropriate reimbursement and minimizing claim denials or delays.
  • Provide clarity on insurance issues to members through clear communication and guidance on insurance issues.
  • Be a resource to ASMBS State Chapters, Access to Care Committee, Membership, and their staff for insurance best practices and advocacy efforts.

Goals

  • Develop and advocate for policy changes that result in appropriate reimbursement rates for metabolic bariatric surgery procedures.
  • Respond to “Insurance Hotline” questions from membership in a timely and helpful manner.

2024/2025 Current Projects

  • Ideal Bariatric Policy – Pending BEC review.
  • Denials Appeals Toolkit, Collaboration with Community/Independent Practice Committee – in progress.
  • Insurance FAQs Update – in progress.
  • Use of Roux en Y Gastric Bypass (RYGB) for Indications Other than Obesity – Draft in progress.

2023/2024 Completed Projects

Apply to Join a Committee

Share your interest in becoming involved with the many ASMBS committees.
Submit Your Application