I started this process a year ago and just got my insurance approval last week. Before they will even set up an appoint for me to get face-to-face with the surgeon and set a date, I had to pay my 30% and sign a contract with the hospital (and the check will have to clear!). Luckily, I knew going in that this would be expected and I am grateful that I was able to get a loan for my part, which is a little over $6,000.00. It's a lot, but I feel so lucky to have this opportunity.
And it's not that the surgeons are so standoff-ish -- they aren't. They come to support group meetings and do the info sessions and some preadmission testing (EGD). I think they just have to make sure the patients are as committed to this tool/lifestyle change as they are to helping us with it.
BTW, I'm new to posting, long-time lurker. Hoping to make lots of friends and join the loser's bench soon!