Understanding Your Laparoscopic Sleeve Gastrectomy Denial
Laparoscopic sleeve gastrectomy is a proven, effective bariatric surgery that removes approximately 80% of the stomach, promoting significant weight loss and resolution of obesity-related conditions. Insurance companies often deny this surgery with extensive requirements or claim it's not medically necessary, despite overwhelming evidence of its safety and effectiveness.
Common Reasons for Denial
- ! BMI does not meet threshold
- ! Insufficient documentation of obesity-related conditions
- ! Required diet program not completed
- ! Psychological evaluation not done
- ! Prior authorization not obtained
- ! Bariatric surgery excluded from plan
- ! Preferred procedure is different surgery
How We Help
We help you document your BMI history, obesity-related comorbidities, failed weight loss attempts, and completion of pre-surgical requirements.
Some Types of Evidence We Can Use For Supporting Your Appeal
✓ Sleeve gastrectomy produces significant, sustained weight loss with lower complication rates than some other bariatric procedures.
✓ Bariatric surgery leads to resolution or improvement of type 2 diabetes in the majority of patients.
✓ Weight loss surgery reduces mortality and improves quality of life in patients with severe obesity.
✓ Long-term studies show durable weight loss and metabolic improvements after sleeve gastrectomy.
Patient Advocacy & Support Organizations
These organizations provide education, support, and advocacy for patients:
Obesity Action Coalition ↗
National nonprofit empowering those affected by obesity through advocacy, education and support.
Frequently Asked Questions
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Disclaimer: Fight Health Insurance is not affiliated with, endorsed by, or partnered with any pharmaceutical manufacturer, healthcare provider, medical device company, or patient assistance program. All information provided is for educational and informational purposes only and does not constitute medical or legal advice. Please consult with your healthcare provider regarding treatment options and with your insurance company regarding coverage decisions.