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What to do? - Choose Your Path and Take Action

You have come this far so we know that you are determined to learn more about gastric bypass surgery or weight loss surgery and further investigate just what it takes to put your life on a path that leads you back to health and away from the deathly grip of obesity. Remember, weight loss surgery is a last resort treatment meaning you have tried and failed to change any one or combination of the following factors/treatments: environmental/behavioral (dietary, physical exercise), biological (pharmacological). If you have, it is time to choose a weight loss surgery practitioner that will lead your way with a complete weight loss surgery program that supports you long after your weight loss surgery.

Lets lay out the path! Aside from choosing a gastric bypass (stomach stapling) or lap band doctor (we will get to that) we need to determine whether your insurance will cover procedures such as the lap band, or stomach stapling (gastric bypass) surgery. If you're lucky, the weight loss surgery institution you choose will handle insurance matters for you. In any event, you might be surprised to learn that many insurance companies will cover the treatment of health problems caused by obesity but not obesity itself. So it is a good idea to have a basic understanding of what your insurance will cover prior to setting up a meeting with a bariatric surgeon. The Obesity Law and Advocacy Center has laid out 10 basic steps to provide some fundamental guidance to both patients and practitioners who want to get insurance claims approved the first time! (Read the article)

It all starts with your primary care physician. You need this person on your team to help you begin to build a case of medical necessity that is documented and signed by your regular physician. Your physician will document your body mass index (BMI), waist circumference, and risk factors for diseases and conditions associated with obesity. Your physician may give you their opinion on gastric bypass surgery (stomach stapling) or purely restrictive weight loss surgeries such as the lap band which you can keep in mind until you visit a weight loss surgeon.

To get preapproved you will need to provide your insurance with information about the bariatric surgeon you will be seeing. (We recommend ObesityDirectory.com to find a bariatric surgeon - nationally.) Once you have chosen a doctor or facility, you can usually set up an appointment to attend a free seminar where they will discuss your BMI, risk factors, the risks and benefits of gastric bypass or the lap band surgery, their weight loss surgery procedures, how your body will be changed, and the necessary lifestyle changes associated with gastric bypass or the lap band surgery or other bariatric procedures.

If the doctor initially believes that you could be a candidate, additional tests may be necessary to support and validate your need for weight loss surgery. Once the practitioner has concluded that you are a candidate for weight loss surgery, he/she will notify your insurance company requesting authorization for weight loss surgery based on your medical conditions (such as any co-morbidities and your BMI) that would most likely improve after bariatric procedures such as a gastric bypass (stomach stapling) or lap band weight loss surgery.

Generally, most institutions will require you to also see the various specialists for preoperative clearance. Your bariatric surgeon or primary care physician can refer you.

In the end, all of this preparation could go to waste if you are not ready to make this life long - life style change. Like an investment, your weight loss surgery institution will be investing a lot of time and effort and you will be investing in your life. So, the assessment of your motivation is a prerequisite for weight loss therapy. For these reasons, motivation for weight loss should be high before initiating your plan of action and usually your doctors will be very conservative in their evaluations. They will assess your attitude and reasons to gage your motivation and seriousness. They will inquire about your outside support team and your environment. They will insure that you have "focused on yourself" in that you have educated yourself and understand your obesity and its associated risks (for example, stomach stapling is not designed to be reversible), and will attempt to gain an understanding as to the reasons any previous attempts at weight loss or maintenance of normal body weight failed or succeeded and will explain how this treatment plan will be different. And lastly, the financial considerations such as having to pay for travel to the weight loss surgery medical facility, time lost from work, and paying for professional counseling that is not covered by insurance.

Your weight loss practitioners office will usually contact your insurance company often to get a status report. It can take as long as a month and a half to hear from your insurance company. Once your lap band or gastric bypass (stomach stapling) surgery is approved, your surgeon's office will call to notify you.

Usually after the insurance authorization is confirmed, you will usually be seen again by your physician. This time a physical examination will be performed and your surgery will be scheduled. You may also be asked to complete a questionnaire related to bariatric surgery and to sign a disclosure statement regarding operative risks and blood transfusions. You will probably be scheduled for a pre-operative seminar. This seminar is designed to give you an overview of your hospital experience, and give you specific information about pre-operative and post-operative hospital procedures.


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