What exactly do I need to do?

So I have attended my online siminar and my research for the RNY Gastric Bypass but now what?

What doctors do I need to evaluate me? Should I see my family doctor first or just go straight to a surgeon? No idea what my next step is. Someone who is going through this or has gone through it, give a little direction for me, please? 

Here's what I did. I went to my family practioner and told her that I was interested in getting the lap band (at that time I wasn't even thinking about a gastric bypass.) so she referred me to a surgeon who wanted me to attend a seminar, which I did, and thats when I decided that a bypass would be the right choice for me. I put together a binder which had letters from Jenny Craig, Weigh****chers and ediets saying that I attempted their programs. I collected all the notes from my doctors stating my co-morbidities and once I visit my surgeon again (May 4th) I am going to bring the binder and hopefully get him to submit a letter of medical necessity to my insurance company. Hopefully, I'm golden. I think the most important thing to remember is to make sure all of your ducks are in a row first. And secondly, make sure you don't jump the gun and skip over doctors. (insurance companies don't really like that) get a referral from each one. Good luck to you! I hope we both have an easy journey through this :)

I think for most insurances, you need to go to your primary care physician and get a referral for the bariatric surgeon.    Once you have your initial consult with the surgeon, they give you a long list of things you need to have done before you have the surgery.  For me, I had to get surgical clearances from a cardiologist, pulmonologist, I had to have a sleep study done, etc etc.  You will have to get referrals for all of these doctors from your PCP in order for them to be covered by insurance.

In addition to those clearances, most bariatric surgeons require you meet with a nutritionist and psychiatrist.

One thing that I wish that I had done was call my insurance company. Some insurances don't have riders for bariatric surgery, in other words thay don't pay for it at all. Speak with a benefits coordinator and ask them what they cover and what you required to do. this would have same me some time and aggravation. i hope this helps!

Being a medical biller, I can assure you that the very first thing I did was go on to my insurance's website and printed off all the criteria I had to meet to get approved for surgery.  Every insurance company is different, so you'll want to investigate what you need to accomplish for them to give authorization and pay.

After that, I saw my regular physician who agreed that I would benefit from RNY.  She made suggestions of hospitals/surgeons.  I researched to find the best hospital in my area for this type of surgery.  They had a program specifically for Weight Loss Surgery (wls) and hooked me up with their surgeon. 

I had to do 6 months of supervised weight loss, a psychological evaluation and a sleep study.  I'm having my RNY next Wednesday, May 9th.

Good luck and I hope this helps!

 I would echo the comments to contact your insurance company.  Be sure you get the criteria for YOUR plan-- which may vary widely.  Some employer's plans do not cover WLS, and there can be wide variances in pre requisites, even which procedures are covered.  Find out who the preferred providers are for your network, if any.

Find out if you need a referral to see the bariatric surgeon.  If you do, see your PCP first.  My insurance plan did not require a referral, so I saw the surgeon first, and they helped me through the insurance requirements.  I needed a letter from my PCP, documented history of obesity for three years, a psych eval, a full cardiac workup (because I was over 55) and three months of dietician visits (not required by insurance, but required by the surgeon).

 I'm with everyone else - Check your insurance first.  

My insurance required me to submit paperwork from my primary physician who had to put down why I met the prerequisites for the surgery.  Once that was completed then I was approved into the program and I had to figure stuff out with my Case Manager. I had to join pay for a nutrition program and lose 5% of my body weight that was for about 6 months.  Once that is complete then I picked a hospital in which only 1 surgeon was approved. (In which I really like so it worked out).  I then had to do a bunch of tests and psych eval and then Thursday it's being sent in officially for my approval but from what my Surgeon's office says everything should go through fine. 

But anyways - it's a lengthily process unless you are paying out of pocket and even then some surgeon's have certain standards. 

GOOD LUCK!!! 

Are you insured through Uniform Medical Plan?  I am and am required to jump through the same hoops as you.  I am getting ready to have my 5% weight loss documented so I can get the actual referral to the surgeon.  Can I ask what tests the surgeon had you complete?

 YAY!! Another WA friend! :) Yes, I have Uniform Medical! :) 

So, because I'm rather healthy (I have Sleep apnea, PCOS and Acid reflux) otherwise my blood pressure is good and no other major issues.  

He had me do the following: 

Blood work (about 9 different things)
Ultrasound
Chest X-ray
EKG
GI Scope (Which I have only the intial appoint scheduled but they are going to send the paperwork in without this - I have acid reflux and haven't been to have a scope done in a while)
Urinealysis
Blood Gas 
See my general practitionar to get a physical
Psych Evaluation (Which I was totally worried about but unless you have some serious issues with food you'll be fine. Most of the things on her questionaires didn't fit me.  I'm not obsessed with food (sugar maybe hahaha) but i'm not really an emotional eater)

Oh and then I had to go on an Atkin's diet. No more then 30 carbs a day to shrink my liver. (Harder then you think).  Although some doctors I've noticed just put people on a liquid diet for 4 weeks.  So, if you don't go with Dr. Chebli then it might be different. 

I have my Pre-op scheduled tomorrow so I can tell you more about that after I go. :) 

I choose Overlake (I live on the Eastside) and I really like Dr. Chebli.  He's funny and has way to much knowledge in his head. hahaha And Lisa who does scheduling and billing stuff is great. 

So, you'll have to do the Accomplish program. Have you paid already?  (Such a pain) I really like my nutritionist her name is Nicole.  Not sure if you can ask for a specific person but she's really great and super sweet.  She helped soooo much losing my 5%.  

I'll add you that way if you have anymore questions you can ask me. 

Adrianne 

Thank you guys so much! Its very much appreciated! So I got in contact with my insurance company today and they said that I had to be reffered to a weight loss management doctor for six months which sucks but its one more step into the door! I