Bariatric surgery approval is a crucial step for any procedure. However, roadblocks can get in the way and disqualify patients. Learn more information by reading these reasons you may be denied gastric bypass surgery.
BMI
Having a body mass index (BMI) below 40 (or the cut off 35), is a common reason why people don’t qualify for surgery. However, some surgeons work on a case-by-case basis and may make exceptions for patients with co-morbidities and weight-related issues. Please note that this is contingent on the surgeon.
Diet
The pre-op diet is just as important as the post-op diet. To enable success and show commitment to a healthy lifestyle, surgeons give patients dietary plans before procedures. In many cases, your procedure approval is dependent on your commitment to the diet guidelines. If you don’t follow orders, the surgeon can deny (or delay) further plans.
Current Health
Another reason you may disqualify for gastric bypass surgery is due to your current health. Of course, obesity can come with its own set of health-related issues (type 2 diabetes, sleep apnea, high blood pressure, etc.), but serious illnesses raise concerns. For instance, untreated infections, active cancer, and advanced liver disease can disqualify surgery approval.
Insurance
Dealing with insurance is tricky, especially when you seek coverage for bariatric surgery. There are various reasons why companies deny surgery, but here are some common factors:
- Your insurance policy excludes obesity surgery and treatments.
- Medical history proves that you’re an unfit candidate for surgery.
- You failed the insurance company’s medical or psychological evaluation for surgery.
- A clerical mistake accidentally caused coverage denial (you can file an appeal for this reason).
What To Do When Denied Surgery?
In terms of coverage denial from your insurance company, you can speak with a representative and discuss your case and the reason for the denial. Additionally, you can file an appeal and state why your insurance should cover the procedure. However, you should discuss medical-related discrepancies with your potential surgeon.
The Best Surgical Team
Weight loss surgery is a procedure that helps many people reclaim their life and form life-long healthy habits. When you’re ready to seek a medical team, you need the best people. If you’re interested in Gastric bypass surgery in Las Vegas, you should consider ALGSN Bariatric. We’re here to help you achieve your weight loss goals. If you have any questions, please contact us today!
