logo
Digestive Care Specialists Now Offering Endoscopic Sleeve Gastroplasty (ESG) With Insurance Coverage in Germantown, Maryland.

Digestive Care Specialists Now Offering Endoscopic Sleeve Gastroplasty (ESG) With Insurance Coverage in Germantown, Maryland.

Business Wire5 days ago
GERMANTOWN, Md.--(BUSINESS WIRE)--Digestive Care Specialists is proud to announce the launch of its Endoscopic Sleeve Gastroplasty (ESG) program in Germantown, Maryland, offering patients a minimally invasive weight loss option with insurance coverage options now available.
ESG is an outpatient procedure that helps patients lose 18-20% of their weight without incisions or surgery.
Share
ESG is an advanced, non-surgical weight loss procedure that uses an endoscopic suturing device to reduce stomach volume, helping patients achieve 18-20% total body weight loss without incisions or removal of stomach tissue. The procedure is performed entirely through the mouth, resulting in faster recovery times, minimal downtime, and fewer risks compared to traditional bariatric surgeries.
'We are thrilled to provide this life-changing procedure to our patients struggling with obesity,' said Dr. Halim Charbel, MD, Gastroenterologist and Endoscopic Weight Loss Specialist at Digestive Care Specialists. 'ESG bridges the gap between medical weight loss and surgical options, giving patients an effective, minimally invasive tool to achieve their health goals.'
Insurance Coverage Now Available
Medicare now covers ESG for patients meeting bariatric surgery criteria (BMI ≥40, or BMI ≥35 with an obesity-related condition such as diabetes, hypertension, or sleep apnea).
Commercial insurance carriers may cover ESG on a case-by-case basis, depending on plan requirements, prior authorizations, and appeals submitted by the medical practice.
'We are excited that Medicare coverage is now in place for ESG, and we are working closely with commercial insurers to obtain approval for eligible patients,' Dr. Charbel added. 'Our team supports patients through every step – from insurance authorization to nutritional counseling and long-term follow-up.'
About Digestive Care Specialists
Digestive Care Specialists is a leading gastroenterology practice in Maryland, specializing in advanced endoscopic weight loss procedures, general gastroenterology, and digestive health optimization. The team is committed to providing compassionate, evidence-based care to help patients achieve better health and quality of life.
The ESG procedure is performed at Holy Cross Germantown Hospital.
Orange background

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Related Articles

Changes In Prior Approval Coming To Traditional Medicare, Medicare Advantage
Changes In Prior Approval Coming To Traditional Medicare, Medicare Advantage

Forbes

time2 hours ago

  • Forbes

Changes In Prior Approval Coming To Traditional Medicare, Medicare Advantage

There were two major announcements recently regarding prior approval of treatments and services for Medicare beneficiaries. In most medical insurance, many treatments won't be covered unless it is approved first by the insurer. It's been a source of controversy for some time. Original Medicare hasn't required prior authorization of treatments and services, with a few exceptions. For most care, providers and the patient agree on a treatment. After the treatment, paperwork for approval and payment is submitted to Medicare. Medicare recently announced a new model program that will test pre-approval. The voluntary model program will test pre-approval for some services and treatments, according to a recent announcement from the Center for Innovation of the Centers for Medicare and Medicaid Services. The model program is seeking medical providers to volunteer for the program from Jan. 1, 2026 through Dec. 31, 2031. The model will be restricted to New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. Providers who volunteer and are accepted will agree to seek prior authorization for 17 items and services, including skin substitutes, deep brain stimulation for Parkinson's Disease, impotence treatment, and arthroscopy for knee osteoarthritis. A provider who volunteers for the program can choose not to seek prior approval for a case. There will be a post-treatment review of the case, and the provider will risk not being paid by Medicare for the treatment. CMS initiated the program and selected the services to be covered because of a series of reports showing waste, fraud or abuse in certain areas. For example, Medicare spent up to $5.8 billion in 2022 on unnecessary or inappropriate services that had no clinical benefit, according to the Medicare Payment Advisory Commission. Under the model, providers will submit the same information they currently submit for payment approval after a service is provided to a beneficiary. The difference is that under the model, the information will be submitted earlier and the provider will wait for approval before performing the services. CMS will select companies to receive and review the prior authorizations. It expects that they will use artificial intelligence and other tools in addition to medical professionals to review the submissions. The companies will be paid based on the extent to which they saved the government money by stopping unnecessary services. CMS said it will manage the program to avoid adverse impact on beneficiaries and providers. There was other news about pre-approval, this time involving Medicare Advantage plans. Pre-approval in Medicare Advantage plans has been controversial recently. There have been a number of recent reports and studies that found the authorization process was delaying treatment or causing patients to abandon treatment plans. Other reports indicated that a high percentage of treatments that initially were denied coverage eventually were approved if the patients or their providers appealed the than 50 major insurers who sponsor many types of insurance plans announced that they will voluntarily streamline prior authorization of treatments and services in all insurance markets, including Medicare Advantage plans. The insurers say they plan to have the new process in place by Jan. 1, 2027.

UnitedHealth (UNH) Is About to Report Q2 Earnings on July 29. Here Is What to Expect
UnitedHealth (UNH) Is About to Report Q2 Earnings on July 29. Here Is What to Expect

Business Insider

time7 hours ago

  • Business Insider

UnitedHealth (UNH) Is About to Report Q2 Earnings on July 29. Here Is What to Expect

UnitedHealth (UNH), one of the prominent players in the health insurance space, is scheduled to announce its second-quarter earnings on July 29. The stock has dropped 43.8% year-to-date, hit by several issues, including the suspension of its guidance, escalating medical costs, and a leadership shakeup that included the sudden departure of its CEO, Andrew Witty. Wall Street analysts expect the company to report earnings per share of $4.48, representing a 34% decrease year-over-year. Elevate Your Investing Strategy: Take advantage of TipRanks Premium at 50% off! Unlock powerful investing tools, advanced data, and expert analyst insights to help you invest with confidence. Meanwhile, revenues are expected to increase by 13% from the year-ago quarter to $111.5 billion, according to data from the TipRanks Forecast page. It's important to note that UNH has an impressive track record with earnings, having exceeded EPS estimates in eight out of the past nine consecutive quarters. On July 24, UnitedHealth Group (UNH) revealed in an SEC filing that it is under formal investigation by the Department of Justice (DOJ) over its Medicare billing practices. The company said it is cooperating with both civil and criminal probes into whether it improperly raised patient diagnoses to secure higher payments from the government. J.P. Morgan analyst Lisa Gill remains optimistic ahead of UnitedHealth's earnings, viewing the DOJ probe as part of a broader industry trend. She maintained an Overweight rating on the stock, expecting a potential rebound despite near-term uncertainty. Analyst's Views Ahead of UNH's Q2 Earnings Heading into the Q2 print, Deutsche Bank analyst George Hill lowered his price target to $328 from $362 but reiterated a Buy rating. The analyst noted that investor sentiment 'has deteriorated significantly' due to a series of unfavorable news. The top-rated analyst lowered his estimates, citing ongoing concerns around Optum Health, the company's healthcare services unit. Also, Leerink Partners analyst Whit Mayo lowered the price target for UNH stock to $340 from $355 and reiterated a Buy rating. He remains 'cautiously optimistic' about the stock heading into Q2 earnings, given the challenging backdrop. Options Traders Anticipate a Large Move Using TipRanks' Options tool, we can see what options traders are expecting from the stock immediately after its earnings report. The expected earnings move is determined by calculating the at-the-money straddle of the options closest to expiration after the earnings announcement. If this sounds complicated, don't worry; the Options tool does this for you. Indeed, it currently says that move in either direction. Is UNH a Good Buy Now? Turning to Wall Street, UNH stock has a Moderate Buy consensus rating based on 18 Buys, five Holds, and one Sell assigned in the last three months. At $348.12, the average UnitedHealth stock price target implies a 23.86% upside potential.

Molina Healthcare, Inc. (MOH) Wins Major Medicaid Contracts in 4 States
Molina Healthcare, Inc. (MOH) Wins Major Medicaid Contracts in 4 States

Yahoo

time11 hours ago

  • Yahoo

Molina Healthcare, Inc. (MOH) Wins Major Medicaid Contracts in 4 States

We recently compiled a list of Molina Healthcare, Inc. (NYSE:MOH) is a leading managed care provider offering government-sponsored healthcare programs like Medicaid and Medicare to low-income individuals and families across the U.S. Headquartered in Long Beach, California, Molina operates health plans in multiple states and serves millions through Medicaid, Medicare, and dual-eligible Special Needs Plans (D-SNPs). The company recently secured major Medicaid contract wins and renewals in states like Georgia, Idaho, Massachusetts, and Ohio, which will contribute to revenue growth and expand access to care. Molina Healthcare, Inc. (NYSE:MOH) also acquired ConnectiCare Holding Co., adding 140,000 members, and previously took over Bright Health's assets in California. A key strategic focus is the dual-eligible population, those covered by both Medicaid and Medicare, due to their complex needs and potential for integrated, high-quality care. Molina is developing blended service models and adjusting policy and reimbursement structures to address this growing segment. A healthcare professional wearing a health communications device discussing patient data with a colleague. Molina Healthcare, Inc. (NYSE:MOH) remains active in community engagement, such as maternal health initiatives in Texas. It's also prioritizing behavioral health and chronic condition management through updated protocols and external partnerships. While we acknowledge the potential of GOOGL as an investment, we believe certain AI stocks offer greater upside potential and carry less downside risk. If you're looking for an extremely undervalued AI stock that also stands to benefit significantly from Trump-era tariffs and the onshoring trend, see our free report on the best short-term AI stock. READ NEXT: The Best and Worst Dow Stocks for the Next 12 Months and 10 Unstoppable Stocks That Could Double Your Money. Disclosure: None. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into a world of global content with local flavor? Download Daily8 app today from your preferred app store and start exploring.
app-storeplay-store