if ur going to mexico and paying out of pocket u dont need to do any of this you just contact whichever surgeon u choose and they will make sure u qualify...i thought my insurance was going to deny me at first too but i was surprised they didnt. I was going to go to mexico if they denied as well...I went a surgeon in july of 2018 before I started anything but I contacted via email my insurance first to see if they covered it, get a list of surgeons in my network and get all the requirements they need to get approved to wls. u should contact ur insurance first b/c not all insurance are satisfied with wwatchers ..goodluck