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The process varies by insurer, but the general steps are consistent: request the denial in writing (the insurer must provide the specific reason), have your prescriber write a letter of medical necessity that addresses the denial reason directly, include supporting clinical data (STEP, SURMOUNT, SELECT trial results), and submit within the appeal deadline (typically 60 to 180 days depending on the plan)
Giles WH, Kittner SJ, Anda RF, Croft JB, and Casper ML (1995)
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Your experience as both a bariatric surgeon and a metabolic medicine physician allows you to guide patients through these choices with clarity and transparency
Glucagon-like peptide 1 and the cardiovascular system
Medically, many programs align to the BMI thresholds mentioned above (BMI 30, or 27 with a weight-related condition) for long-term options
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