The following is a checklist you can use to ensure you have the information needed to get your surgical weight loss procedure approved. Every insurance company sets up a list of criteria for approval of weight loss surgery. This checklist was created with this in mind. 

Weight loss surgery insurance benefits
Check your benefits. Call the customer service number at your insurance company, and ask for the benefits department. Ask if you have insurance benefits for medical treatment of obesity or weight loss surgery. Ask if the following procedures and cpt codes are covered under your plan: Laparoscopic Roux-en-Y Gastric Bypass (43644) and Laparoscopic Placement of an Adjustable Gastric Band (43770). This information can also be found written in your policy on the exclusions page.

Supporting Doctor Statement
We ask for a letter from your primary care physician or weight loss surgery specialist who supports your need for weight loss surgery treatment. Your doctor should list the various co-morbid conditions for which he/she is treating you. The letter should also state that significant weight loss might halt the progression of these conditions, as well as make them easier to manage. It should also reflect your medications. An example of a letter will be included in your information packet.

Diet Records
You may be asked to provide documentation of all recent medically supervised weight loss attempts. The insurance company can, and often will, deny you if you don't provide them with proof that you have tried physician-supervised weight loss attempts. Be sure to have at least one visit per month with your primary care physician over a six-month period (or period required by your insurance company) documenting your progress. The weight loss attempts do not have to involve medication, they can be exercise, low calorie diets, etc.

Medical Records
Medical records are essential to establishing medical necessity of your weight loss surgery treatment. Any doctor visits, surgeries, lab results, diagnostic procedures and ER visits should be included. Request records pertaining to your weight and any conditions worsened by your weight (i.e. Hypertension, Diabetes, Degenerative Joint Disease, etc.). We only need records from the past two years, unless your insurance indicates a need for more.

A preoperative psychological evaluation is an essential component of preparing for your weight loss surgery procedure. The importance of obtaining a thorough psychological assessment cannot be overstated. What makes a thorough exam? A detailed clinical interview, in addition to objectively scored psychological tests are the basics of a comprehensive psychological evaluation. Many insurance companies require an evaluation. The bariatric surgeon requires an evaluation for all patients.

The best preparation for your weight loss surgery treatment is to understand everything you can about your specific bariatric procedure. Our team is committed to helping you achieve your weight loss goals. The path you have chosen can give you a healthier lifestyle. Take advantage of the time you have between your application and approval for the surgery! At the Nevada Surgical Weight Loss Center, we realize that this is an important and often emotional decision but we also realize that there are many changes coming and many new skills to be learned. Start now with your preparations!

Here are some suggestions that can be started right away:

1. Gradually decrease the amount of caffeine you are consuming. Weight loss surgery patients who stop caffeine suddenly at the time of surgery may experience symptoms of withdrawal such as intense headaches. Remember that there is a significant amount of caffeine in coffee, tea and many soft drinks.
2. If you drink carbonated beverages, now is the time to stop. Why? When a cold compressed gas (carbonation) hits a 99.5 degree closed system (your stomach) it expands.
3. Start a program of aerobic activity such as walking or swimming for 20 minutes, 4 times a week. Always obtain physician approval before starting any program involving physical exertion.
4. Stop smoking. Tobacco interferes with your lungs' ability to exchange oxygen. Also, nicotine impairs circulation and consequently may impede healing after weight loss surgery and predispose you to infection or ulcers.
5. Reduce the amount of refined carbohydrates you consume. Refined carbohydrates include foods such as white bread, rice, pasta and cookies.
6. Start a journal, list 100 reasons to lose 100 pounds.
7. Get your affairs in order.