Where do you Start?

[Guest mbp]

I have multiple medical problems and my PCP suggested gastric bypass surgery. But with all the research I really want to go with the Lapband. So who do I go to get initial approval my PCP or do I select a doctor out of the yellow pages! In simpler terms "who gets to write the insurance company to plead my case!"

Thanks

Mel

[It's me-Debbydo 0]

Not that simple: Research bariatric surgeon's in your area, they will have requirements for you to meet medically even before ythe surgeon's office goes for preapproval from the insurance carrier.

There are some really good thread in the archives about this, surf this site there is a wealth of information

Good luck

[Alexandra 55]

Mel, a LOT depends on what your insurance carrier's requirements are. If your PCP already recommended bariatric surgery to you then you're on your way. Your PCP should be able to refer you to a surgeon in your network--even if formal "referrals" aren't required by your plan, getting your doctor's suggestion is preferable to picking a doctor out of the yellow pages. If your PCP can't help, call your carrier! You are looking for a bariatric surgeon, or a general surgeon who does bariatric surgery. Depending on where you are in the country and your insurance situation this may give you none, one, or many choices.

Then you make the appointment with the surgeon and take it from there. Ultimately it's the surgeon who will make the formal request for precertification from your carrier, but he will need lots of supporting information from your other doctors. If you have multiple medical conditions this may be a time-consuming process, so get started. And good luck!!