Question:
Do I need certain tests first?
I filled out an insurance form on Dr. Stewart in Denton TX website...1 week ago. My BMI is 50.......do I need to have sleep tests done before they approve or deny me? — melanie L. (posted on March 16, 2004)
March 15, 2004
It's up to your Dr and Insurance Company.
— M B.
March 16, 2004
Hi I just had my surgery 3/4/04...My BMI was close to 60 and I had no sleep
test. I don't have sleep apnea or any other severe co-morbitities. All I
had to do was some blood work, an EKG, and a gall bladder ultra-sound. But
every bariatric surgery center and insurance policy is different. Good
luck!
— mzcath
March 16, 2004
The other poster ids correct. It is up to your insutrance company and
su=rgeon. You will HVE TO get a Psych test done. Thast is by law. You
probsblly will have to get other testing done to make sure you can go
through the surgery succesfully.
— shalandar
March 16, 2004
I should think uyou'd have anumber of different tests performed BEFORE your
doctor submits to insurance for approval. I've neverheard of a LAW that
you have to have a psych eval. (something going on in TX that I need to
know about?) It is, however, most often, a requirement of some Dr's and
some insurances that you have a psych eval as part of the approval process.
Along with the psych eval, at a minimum you would have a full physical and
any specialists tests that your health history or complaints would indicate
necessary to rule out problems.
If you are confused, I'd speak directly to the surgeon's office, since
every dr's proceedure is so different. SOrry to not be that helpfull. But,
good luck to you.
— LMCLILLY
March 16, 2004
In many instances insurance companies only require that you have a BMI of
40 or greater to approve you for surgery. However, I would be very wary of
any surgeon that does any surgical weight loss procedure without the
appropriate preoperative evaluations. Medical testing prior to surgery is
in your best interest and can include complete physical, cardiac workup,
pulmonary tests, sleep study, psych eval and more depending on the
individual. While all patients in our program have a psych eval there is
no law on a state or national level that requires a psychiatric evaluation.
Just be very careful if your surgeon is not sufficiently evaluating you
prior to surgery. Best wishes!
— ronascott
March 16, 2004
Usually once you go to your initial consultation the Doc will refer you to
the Specialists you need to go to. Some surgeons have a "network"
they use and won't accept just anyone. My surgeon (and insurance) requested
several tests and the specialists were out of my health care network, so of
course I had to pay cash. Hope this helps.
— Ruthie B.
March 16, 2004
Nope, no laws in Tx about mandatory psych tests. Neither my dr. nor my
insurance required me to have one.
<p>
There is usually two rounds of testing, the first comes after your initial
consult, but before the dr. submits the paperwork for insurance approval.
These can include sleep apnea testing, psych evaluation, bloodwork etc. I
had to have cardiac clearance because I had used diet pills with ephedra in
the past. Each dr. will have different requirements, as will each insurance
company. These tests help the dr. make the case for medical necessity of
the WLS.
<p>
The second round of tests come after the ins. approval and close to your
actual surgery date. They can include bloodwork, EKG, chest x-ray, and
maybe an endoscope. These depend on the patients state of health,
co-morbids, etc.
— Ali M
March 17, 2004
Dr. Stewart is my surgeon. I had a sleep study, psych eval and had to had
cardiaic clearance.
It will depend on your insurance and your health as to what tests need to
be done. I had to have a psych study because I had been diagnosed with
depression several years ago. I also had seen a cardiologist for an another
problem so they required cardiac clearance. Call and talk to Leah and see
will let you know exactaly what they will need done. She is wonderful to
work with!
Jen
— mollymom
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