Question:
Do I have to go to a surgeon or can I ask for predetermination myself from insurance?

I have completed all my appeals with my first request. I am ready to start this procedure over and need to know if I may start this process this time myself by asking my insurance for approval. I am now 6 lbs from being 100 pounds over weight of course I have lots of comorbites that they never acually considered. They just kept looking at my original 35 BMI. I am now 38.7 BMI    — CINDY D. (posted on August 28, 2003)

August 28, 2003
With your very borderline BMI it will be critical that the surgeon submit a letter explaining your co-morbs and why at 35 you meet the NIH criteria. It needs to be very serious co-morbs to be approved under a BMI of 40. Your insurance may also require a letter from your PCP. While they knoew what they are doing I think a WL surgeon potentially can do a better letter. Make sure you summarize everything that you think should be included in the letter for the surgeon. Sort of do their work for them. You can submit the package and put some other things you want to be factored in, like the impact the weight is having on your life etc., but have the surgeon's letter there as the "expert" piece of the submittal. Good Luck!
   — zoedogcbr