What is a precertification letter and who writes it?

I am in the midst of the waiting game. I am waiting for my 2nd opinion and also the final outcome from my 1st surgeon if he will do LAP with my BMI of over 60. I want this go smoothly. It is so hard to believe that I have been working on this since May and still am hanging. Anyway can I get this precertification letter first so as soon as the doc says O. K. I can be on the road to WLS with out too much more delay? Is it possible? Thanks again to everyone out there!!!

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