Oh yes.... I was done with my classes, labs and evaluations in October. A UHC adjuster first closed my file because they claimed my surgeon's office forgot a page in the fax of my weight history and the adjuster wouldn't wait another business day to get it. Random. So the next day, they had to open a second file for me with the completed paperwork re-sent...........and it took a full month to hear back, only for them to deny. If I had gone off what the generic denial letter said, I would have had no clue why. Thankfully, my surgeon called the UHC medical director to see wtf was going on. It was because they claimed that page on the weight history was still missing. My surgeon corrected them and had someone from the office re-send the same damn thing again and they overturned it. I got my official approval about a week later. They are seriously sketchy on the tracking of paperwork, in my exerience. Also, they made massive errors in billing my pre-op labwork and expensive (covered) tests. I had to correct them a ton of times. Just stay on it, and if you can get your surgeon's office (or better yet, your surgeon) to call them for you, that might get faster reaction.

 
No, you do not have to go with what your insurance covers.  People appeal their surgery choices all the time and get the surgery choice they want.

But, you have to do what is right for you.  If you want RNY, go for it.

 
I believe you should qualify based on your BMI alone.

May I ask you to rethink bypass?  For a BMI of 61 you'll want to lose quite a bit and usually bypass buys you about 100#.  You will only malabsorb calories for 6-24 months but you will malabsorb nutrition for life.  Bypass has a very high failure rate, regain is a buggar.

One of the big problems with bypass is that over time often the stoma dilates.  There is nothing holding food in your stomach so you get the satisfied/full feeling.  When this happens people are always hungry and always eating.  Considering after a couple of years you are no longer malabsorbing calories that is when the regain starts.  Bypass has a minimum of a 20% failure rate at the 5 year point.  Risks and complications are pretty darn serious with bypass.  They are finding seizure disorders, reactive hypoglycemia, malnutrition, bowel obstructions, ulcers, and all kinds of problems with bypass long term.  Reactive hypoglycemia is another reason for weight gain in bypass folks.  Those are not issues I would want to deal with.  Thing is, you can have a text book surgery with the best surgeon in the business and the most compliant patient in the world and you still can have major, significant, life altering complications.  Also, with bypass you can never take NSAIDs again.  No Motrin, aspirin, none of those drugs.  What will you do when you are old and arthritic?  You are left with Tylenol and narcotics for the most part.

Have you done serious research into the sleeve or DS?  Please just consider looking at all your options, you have to live with this surgery for the rest of your life.  Nobody else, just you.  Get the best surgery type for you.

Sleeves are the safest surgery type long term, DS is the most effective surgery type long term. No seizure disorders or much of the other nonsense.

Are you a sugar and high fat person?  DS is your best option.  If you are not a grazer but you just eat mega meals then sleeve is a better pick.  With a sleeve your stomach is just smaller, same weight loss results as bypass without the dumping, bowel obstructions, blood sugar issues, and you can take NSAIDs.  DS is kinda cool in the sense that you malabsorb 80% of fat, 50% of protein, and about 40% of complex carbs.  So if you eat a bowl of ice cream you'll malabsorb 80% of the fat but you will absorb all the sugar.  No surgery type fixes flour/sugar.

There is a person that is very well versed in DS and bypass, her ID is MsBatt.  I would track her down and PM her.  She's great at explaining the DS anatomy vs. bypass anatomy and she can explain even better why DS really is superior in every way to bypass.  And with DS (unlike bypass) you will malabsorb calories forever.

 
A COE does not reflect on the skill of the surgeon.  Some of the biggest bariatric butchers are COEs.  It basically means that they filled out the right papers and paid their fees.

I'm not suggesting Dr. Ellner is not good, I've never heard of this doctor.  I just want to make sure you aren't picking someone based on COE affiliations only.

 
It really goes by your BMI more than anything and here is a BMI calculator:

nhlbisupport.com/bmi/bmicalc.htm

MTF... meaning on base vs. off?  What little I know is that they will approve a sleeve ON base but not off.  I see a lot of people posting that they are unable to have that particular surgery type because of this but (and please someone, correct me if I am wrong) they will approve bands or bypass.

Most ins co's want you to have a BMI of 35 or greater with specific comorbidities or a BMI of 40 with or without comorbidities.

What is your BMI and what surgery type are you interested in getting?