Hi Stacey,
There are 2 entities in the "approval" process. Your insurance company's requirements and your surgeon's requirements. Almost always, they are the same list. I strongly advise you to go with a surgeon who has a lot of experience in getting approval from insurance companies, is familiar with what they require, is willing to contact your insurance company to find out specifics - that should be part of what his staff does for you as a patient. Also ask what they do if there is a denial - you want a staff that KNOWS how to handle those and fight for you in an effective and prompt manner.
Sometimes, a surgeon will require more than the insurance company because he knows more about your specific health issues more than an anonymous insurance person sitting at a desk. Like a sleep study for suspected or confirmed apnea, or more extensive blood studies or any studies that he feels need to be done based on any health issues you may have. Surgeons do this because it is "due dilligence" AND they don't want to have a dead patient or complications! So it is good they do these tests, for all concerned. Even if you don't do the very best on any of these tests doesn't mean you won't be approved, it simply means the Dr. has more info in which to insure your success by knowing things ahead of time. Virtually ALL WLS patients present with many physical problems, hence why we need the surgery.
You can start by calling your insurance company and ask for benefits info and ask if WLS is covered, what types and what is required to be approved. They will have a specific list you will have to comply with. At least, this way you will know one way or another. Write down what they say (or better yet, request a copy sent to you) and have it with you when you go see surgeons. If possible, choose a surgeon that has a comprehensive program (support group, nutritionist, psychology referrals or one on staff and hopefully a bariatric nurse practitioner that runs the place, co-ordinates his office with insurance, deals with you and your problems, questions, issues, etc). Some surgeons have all this, some farm you out to all these services. A good place to look is local hospitals, as many of the now actually have WLS centers in them now and lots of programs within them to help you on your way.
Know this: In the very beginning, where you are now, you will get overwhelmed with all the info, requirements, issues, obstacles, appointments and everything else this journey will ask of you. Don't freak! It's like that for all of us! You are not alone! Don't let the overwhelm stop you or make you doubt yourself. All this will make you stronger and you WILL get through it - all this will come to mind when, farther down the road, when someone even TRIES to say you "took the easy way out" you will be sufficiently armed with the self knowledge that it is NOT easy. But it is marvelously successful and they are probably jealous, so nya nya nya to them! =)
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