I need help understanding this policy, has anyone else had this with their insurance

I called insurance company yesterday to find out if I need a refferal to surgeon. I was told that I didn't need a referral, but the doctor would have to write a letter of medical necissity for any type of weight loss care and that it would have to be pre-authorized before I seen anyone includina a dietician or nutrionist (sorry for the misspelling) help

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