Pathway to Surgery

 

Insurance Requirements

Each insurance company has its own requirements and criteria for weight loss surgery. We will work with you and your insurance provider to help navigate this process.

Please understand that the Bariatric Coordinator must receive the Letter of Medical Necessity before your packet can be submitted to your insurance company for approval.

A Letter of Medical Necessity is required in order to obtain approval for your bariatric surgery.  A Letter of Medical Necessity states why significant weight loss is medically necessary for a patient and usually includes the following information.

  • Patient’s weight (BMI more than 40 or more than 35 with associated medical problems to qualify)
  • List of medical problems associated with obesity, such as hypertension, diabetes mellitus, sleep apnea, etc.
  • Number of years patient has been overweight (which should be at least five or more)
  • Documentation of failed weight-loss programs attempted for a minimum of 6 months in the past 2 years

How should you prepare?
Detailed Overview