Financial Information- Dean - WI

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Financial Information


Dean Health Plan Members

If you have insurance through Dean Health Plan, you can check your insurance plan coverage by visiting this site's Member Benefit Information section.

You can also call the Dean Health Plan Customer Care Center at (800) 279-1301.

Insurance Coverage

If you are considering any weight loss program or bariatric surgery, your first step should be to contact your insurance company to find out what costs will be covered by your plan.

Please note that coverage of weight loss programs or surgery varies by insurance company. Many insurance companies do not include weight loss surgery or treatment of obesity in their coverage. If your health insurance does not cover the cost of weight loss surgery, you will need to pay all medical bills related to the procedure.

Even if your insurance covers some costs, most insurance companies require documentation of adherance to a six-month physician supervised weight loss program in the previous year before bariatric surgery. Your company may require discussions regarding physical activity, nutrition and behavior modification.

Please note we will not schedule an appointment until we receive insurance authorization, or until payment arrangements have been finalized.

Approval - Bariatric

Approval Process for Bariatric Surgery

If you have been approved as a candidate for bariatric surgery by the bariatric surgery team, a prior authorization letter will be sent to your insurance company.  

You will be asked to meet with a member of SSM Health to make payment arrangements. Once we have received approval from your insurance company and/or SSM Health, we will contact you to schedule another appointment to discuss the next steps for surgery.

It is important to note that your insurance company will notify both Dean Medical Group and you regarding your approval status. If you wish to find out the progress of your request, please contact your insurance company directly.

Please be aware that the evaluation and insurance/payment verification process may take APPROXIMATELY 6 MONTHS TO COMPLETE.

Insurance Details

Necessary Information When Contacting Your Insurance

Your insurance provider will likely have a list of specific questions they'll ask when you contact them to learn more about their weight management coverage. Please have the following information accessible before you contact them.

Non-surgical Program

  • Provider names: Dr. Susan Isensee or Dr. Janet Droessler
  • Initial visit type codes:  
    • New patient visit type: 99244 or 99204
  • Diagnostic codes
    • Obesity: 278.00 (BMI 30-39.9) Or  
    • Morbid obesity:  278.01 (BMI >40)
    • Additional diagnostic codes you may need:
      • High blood pressure:  401.1
      • Diabetes:  250.02
      • Sleep apnea:  780.57 
      • High cholesterol:  272.0
      • Hyperlipidemia:  272.4

Surgical Program

  • Provider name:  Dr. Franklin Bendewald
  • Site name:  SSM Health St. Mary's Hospital - Madison 
  • Bariatric surgical procedure codes:   
    • Gastric Bypass:  43644
    • LapBand:  43770
    • Sleeve Gastrectomy:  43775
  • Diagnostic codes
    • Obesity:  278.00 (BMI 30-39.9)
    • Morbid obesity:  278.01 (BMI >40)
    • Additional diagnostic codes you may need: 
      • High blood pressure:  401.1
      • Diabetes:  250.02
      • Sleep apnea:  780.57
      • High cholesterol:  272.0 
      • Hyperlipidemia:  272.4


Program Costs

If you are interested in obtaining specific costs related to the Gastric Bypass or LAP Band procedure, please contact SSM Health Weight Management Services staff at (608) 824-4457 or toll free, (800) 808-1190.

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