How to Get the Approval For Gastric Sleeve Surgery?

Gastric sleeve surgery is a highly successful weight reduction operation. According to studies, the majority of patients lose weight quickly and continue to do so for 18 to 24 months following the treatment. This reflects a success rate of 80-90 percent.

So, why is it difficult to acquire approval for gastric sleeve surgery? There are several elements that determine someone's eligibility for a gastric sleeve. Given the surgery's long-term impact, these considerations are both physiological and psychological. So, to acquire permission and speed up the procedure, you need to perform a few things.

What Makes You Eligible for Gastric Sleeve?

Gastric sleeve surgery is typically used as a last option when all other weight loss procedures have failed. Furthermore, the person must have satisfied the following:

• Have a BMI of 40 or above;

• In most circumstances, you can qualify if you have serious health issues caused by obesity, such as Type 2 diabetes, sleep apnea, or high blood pressure. As such, your BMI should be between 35 and 39;

• 18 to 75 years of age;

• Psychologically prepared to undertake permanent lifestyle adjustments.

Most doctors, surgical centers, and insurance companies will enforce these rules. They will eventually have an impact on whether or not you can acquire surgery permission and how swiftly.

The Insurance Process

The insurance procedure for bariatric surgery differs according to people, insurance providers, and policies. This is not a short procedure. 

The first barrier to gaining a rapid clearance is the insurance company's overwhelming workload. Companies with little time seldom respond to inquiries immediately. They must deal with a large number of pre-approvals on a daily basis.

Second, most insurance companies want to ensure that bariatric treatment is medically essential. They will thus subject you to a battery of tests and, in some circumstances, three to six months in a medical weight loss program that you must complete prior to surgery.

Once these tests are completed, the insurance company will determine if a gastric sleeve is warranted.

This differs from the widely held belief that insurance firms design these assessments to deter people from continuing the procedure.

How Long Does Surgical Insurance Approval Take?

Most patients receive permission for gastric sleeve surgery within 90 days, or 12 weeks if no medicinal weight loss regimen is necessary. However, continuous office visits are required throughout the approval procedure.

This procedure may take longer if the insurance company requires more testing and documents. You may speed up this process by engaging with the organization on a frequent basis to determine what they require at each level.

What to Do While You Wait

Most individuals squander time seeking pre-approval for a gastric sleeve treatment. That should not be the case. Following your initial appointment, the surgeon or medical staff will have conveyed what you need to do before surgery and the complete procedure that will follow. 

So, take this opportunity to begin working on your diet and exercise routine. Start reducing weight and quitting smoking. This will increase the success percentage of the procedure.

Furthermore, after the insurance provider gives its clearance, you'll have accomplished the majority of your pre-op requirements.

What You Can Do To Shorten The Wait

It's virtually tough to persuade the insurance company to authorize your operation sooner. However, there are techniques to help the procedure go more smoothly. First and foremost, be organized. Begin the procedure by calling your insurance provider. You'll learn what you need to do to qualify for the operation. You may also be assigned a coordinator who will assist you in performing a preliminary verification of your insurance coverage and proceeding from there.

Once you've grasped the documentation and what's required of you, begin compiling it swiftly and carefully. It might take weeks to get your pre-approval reconsidered or reversed if it was refused for any reason, including omission. So, if you have any questions, contact your surgeon and insurance provider for clarification.