Newbie Questions?

[Lovelycurves 94]

Hello everyone, I recently started looking into getting gastric bypass as I've gained a ton of weight and I've done every diet out there to lose weight to just gain instead. My highest weight recorded is 336lbs. But I've been at 350 now I'm at 330. I have high blood pressure due to my weight. And I'm at high risk of diabetes and high cholesterol. (Although my doctors are very happy with my blood work) anyways I was just curious what the process is to get the rny approved through insurance. I am 330lbs 21yrs old and about 5'6, my bmi is calculated at around 50 (maybe a little higher I'm not 100% sure) I'm going to seminar tomorrow 8/21 then setting an appointment to see surgeon asap! I was just wondering what the process is what tests usually are needed to be done preop. I've done some research but would like to hear what actual people who's had it done have to say about it. I'm very curious what everyones input is about this is. Sorry for rambling on and hope to hear some input on this thanks!

[TinyMamiOf3kids 1,280]

Hello I got the approval from my regular doctor for surgery. Then meet with the surgeon that wanted me to do endoscopy stress test EKG blood work. Physo stuff and dietician

[tamihill 24]

Have you checked your Insurance to see if they cover bariatric surgery? And if they do what are the requirements you have to meet..

[LosingItForMe2011 320]

First step is to call your insurance company to make sure they do pay for bariatric surgery when all requirements are met.

Then after your initial information meeting they'll probably provide information you need to get your appointments started. Each bariatric group is different and require different tests before THEY will approve you for surgery. Generally they will approve you when they know your insurance will agree with their decision and they'll submit all the paperwork for you to the insurance company for the approval. They will also work with your insurance to get the approval should your insurance wants more info or requires more testing etc.

Because each bariatric group and each insurance is different it's very difficult to pin point what is required for you to get approval. Your BMI alone is already high enough to get approval from most insurance companies. Adding co-morbidities such as high blood pressure just about assures it for most insurances. Some insurance do require a minimum of 3-6 months, some a year, of supervised weight loss weigh-ins. Your bariatric group can help with that. Good luck!

[lovealways 287]

Like everyone else says, double check to make sure your insurance covers gastric bypass. You are on the right track by attending the seminar and scheduling an initial consult with your surgeon! My surgeon required a lot of pre-op testing, but I don't mind, because the more testing you have, the better your chances are of showcasing how much you need this surgery for your health. Pre-op testing included a psych evaluation, cardiology consult and stress test with EKG, extensive blood work, consult with a gastroenterologist and upper endoscopy, sonogram of the abdomen to rule out gallstones, two sleep studies, pulmonary consult, informational seminar, 2 support groups, and I think that's it. My insurance has required a 6 month supervised weigh-in/diet and I also have on my file a 6 year hisory of weight from my doctor...they don't ask for it, but I thought I'd get it anyway to up my chances of being approved.

The testing is extensive, but worth it. If you get stuck doing a 6 month supervised diet, don't be discouraged. A lot of insurance companies require either a 3 month or 6 month supervised diet to weed out anyone who doesn't have the patience and time to committ to it. Remember, insurance is looking for anyway NOT to pay, so don't give them a reason to!

It's quite a journey, but many have said that patients who have the most success long term are those that have a journey...those that don't get approved in 2 months and then have the surgery. Time really does help to gather information, ready your mind, and your body.

Good luck!

[Lovelycurves 94]

.