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How to Get Approved for Bariatric Surgery

Bariatric surgery is a procedure used to promote weight-loss by limiting the amount of food ingested and through nutrition malabsorption. A mini-stomach is created by surgically dividing the stomach, creating a pouch that can hold a few bites of food and the intestines are cut and attached to the new stomach pouch, according to the UCLA Health System. Physician approval is needed for this type of surgery, as well as approval from your insurance company.

Things You'll Need

  • Bariatric surgeon
  • Primary care physician referral
  • BMI > 40 or BMI > 35 with medical conditions
  • Insurance pre-approval letter
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Instructions

  1. Bariatric Surgery Approval

    • 1

      Find a bariatric surgeon either through a referral from your primary care physician, your health insurance company, or through the American Society of Bariatric Physicians that is contracted with your health insurance plan. Set up an appointment to find out if you are a candidate for bariatric surgery. Bring any letters or documentation from previous physicians indicating why it is necessary for you to undergo weight-loss surgery.

    • 2

      Pass basic medical qualifications for bariatric surgery. According to the Medical University of South Carolina, you must have a BMI greater than 40 or a BMI greater than 35 with additional health problems like high blood pressure, diabetes, or sleep apnea. If you do not meet this criteria, you will denied as a candidate for bariatric surgery.

    • 3

      Attend information sessions or classes that your physician requires potential bariatric surgery patients to go to. Attend nutrition and exercise classes as required by your physician to make sure this is something you can do after your surgery. If you cannot follow a post-surgery diet and exercise routine, your physician may not approve you for the surgery.

    • 4

      Pass the physician criteria to be approved for bariatric surgery. This entails undergoing a series of laboratory and medical tests to make sure you can medically handle the surgery, as well as a mental evaluation from a psychologist. For your physician to approve you for bariatric surgery you must be able to show him that you have tried diet and exercise programs in the past that failed to work or documentation of any supervised medical diet programs that failed to work.

    • 5

      Get authorization or pre-approval from your insurance company that they will cover the surgery costs according to your plan. Make sure your bariatric surgeon sends supporting documentation to the insurance company stating how long you have been overweight, your height and BMI, weight causing limitations, history of dieting and exercise efforts, and medical issues caused by being overweight. Your insurance company will not approve your surgery without all supporting documentation and your physician will not perform the surgery without payment authorization.

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