Qualifications and benefits of weight loss procedures

1. Attend a seminar.
2. Make a list of all the diets you have tried and bring it with you to your doctor.
3. Bring any pertinent medical data to your appointment with the surgeon—this would include reports of special tests (echocardiogram, sleep study, etc.) or hospital discharge summaries if you have been in the hospital.
4. Bring a list of your medications with the dose and schedule.
5. Stop smoking. Surgical patients who use tobacco products are at a higher surgical risk.

Medical problems, such as serious heart or lung problems, can increase the risk of any bariatric surgery. On the other hand, if they are problems that are related to your weight, they also increase the need for bariatric surgery. Severe medical problems may not dissuade the surgeon from recommending gastric bypass bariatric surgery if it is otherwise appropriate, but those conditions will make a patient's risk higher than average.

Certain basic tests are done prior to bariatric surgery: a Complete Blood Count (CBC), urinalysis, and a chemistry panel, which gives a read-out of about 20 blood chemistry values. Often a glucose tolerance test is done to evaluate for diabetes, which is very common in overweight persons. All patients, except for children, get a chest X-ray and an electrocardiogram. Other tests, such as pulmonary function testing, echocardiogram, sleep studies, GI evaluation, cardiology evaluation, or psychiatric evaluation, may be requested when indicated.

Payment may be denied because there may be a specific exclusion in your policy for obesity bariatric surgery or "treatment of obesity." Insurance payment may also be denied for lack of "medical necessity." A therapy is deemed to be medically necessary when it is needed to treat a serious or life-threatening condition. In the case of morbid obesity, alternative treatments—such as dieting, exercise, behavior modification, and some medications—are considered to be available. Medical necessity denials usually hinge on the insurance company's request for some form of documentation, such as 1 to 5 years of physician-supervised dieting or a psychiatric evaluation, illustrating that you have tried unsuccessfully to lose weight by other methods.

Gather all the information (diet records, medical records, medical tests) your insurance company may require, before your consultation. This can help reduce the time it takes to navigate through your insurance plans process.

After all pre-operative tests have been ordered and results have been received, your surgeon’s office must mail or fax your information to your insurance carrier. Insurance carriers’ time frames vary from 1 to 4 weeks to respond to your surgeon’s request for the bariatric surgery.