Bariatric Surgery: The Step-by-Step Process
Anyone considering weight loss surgery to treat morbid obesity should be aware of everything that is involved in this journey. The following 10 steps outline the process.
STEP 1 - Pre-Qualification. The first step is to determine if you are a candidate for weight loss surgery. The National Institute of Health has set forth guidelines to determine who is an appropriate candidate for weight loss surgery. Your insurance company and your surgeon will abide by these guidelines.
STEP 2 – Meet With A Bariatric Surgeon. Eligible weight loss surgery candidates should schedule an initial meeting with the bariatric surgeon of their choice, as well as staff members from the bariatric surgery program. You also may want to talk to people who have had the surgery. During this meeting, the surgeon will give you an overview of the process that will include information on all treatments for morbid obesity as well as surgical options, and the risks and benefits of each. This is the time to ask any questions you have. You should also get comprehensive information about the insurance approval process, and have the opportunity to ask questions.
STEP 3 - Confirm Eligibility. Next, your surgeon will review your height and weight to determine if you meet National Institute of Health criteria. To be considered a candidate for surgery, you must have a body mass index (BMI) of 40 or higher, or a BMI of 35-39.9 if you have other health conditions that are related to obesity. At this point, the surgeon must determine if the benefits of surgery outweigh the risks; this is done by a review of your health history. After your eligibility is confirmed, you will need to find out if your insurance will cover the surgery, and what financing options are available.
STEP 4 – Verification of Insurance Coverage. At this point, you need to know if your insurance will pay for surgery. Obtaining coverage for bariatric surgery can be very complicated. Unfortunately, some insurance companies and employers have put exclusions in health insurance policies. So even if your surgery is deemed medically necessary, you may not get coverage for this type of surgery. This means you may have to consider changing insurance carriers or paying for the surgery on your own. Every insurance company has different rules about bariatric surgery coverage, and your specific policy may have different requirements.
STEP 5 - Insurance Processing. Finally, you have been accepted as a patient and it’s time to get your insurance coverage approved. As stated before, every insurance company has different requirements for approval and your individual policy may have additional requirements. Various medical records will be necessary to document your history of morbid obesity, and your insurer may need to obtain all of your records about diet programs you have participated in. You may need to go on a medically supervised diet in order to get approval. Bariatric surgery is the only medically necessary treatment that requires written approval from your insurance company.
STEP 6 - Pre-Operative Testing. Now you are ready to set a date for your surgery. This will be based on your schedule and your surgeon’s schedule. At this point, pre-operative testing must be done. Pre-operative testing requirements are based on your health history, your current medical condition, and your BMI. The procedure you are having will also determine what testing will be required. If your tests results are abnormal, your surgeon may order additional tests.
STEP 7 - Pre-Operative Education and Informed Consent. Another pre-operative requirement is to meet with a dietician, who will give you extensive information about your procedure and your post-operative diet. You should be prepared to ask any questions you may have about your post-operative diet and follow-up care. You may also want to attend a support group prior to your surgery. And you may be required to sign a bariatric commitment form, which indicates your commitment to following the surgeon’s orders, recommendations, and follow-up schedule.
STEP 8 - Visit With Surgeon, Review History and Process. You will have an appointment with your surgeon 1-2 weeks prior to your surgery. Before this, your surgeon will have reviewed your health history and all of your test results. During this appointment, your surgeon will review your health history, current medical condition, test results, medications you are taking, and give you a physical exam. Then, your surgeon will review the surgical procedure, discuss the risks of the surgery, review informed consent and answer any of your questions. If any abnormal test results have turned up, your surgeon will discuss this with you at this time. Otherwise, the next step is surgery.
STEP 9 - Hospital Admission
STEP 10 - Follow-Up Care