MegHealthy

Good Morning everyone! I am 5'5" and 243lbs. That puts me right at a 40.4 BMI. From what I understand my BCBS of GA requires that I participate in a non-surgical weight reduction regimen for at least 6 continuous months. During that time BCBS requires of the 6 month program as follows:

The clinical record includes:

• A description of “what” the individual actually did in the program, that is, did they follow the diet and exercise recommendations as an active participant for six continuous months in the two years prior to surgery?

• A record of the individual’s weight at the time of each preop visit, and the amount of weight loss achieved each month of the documented 6 month period

• A description of the actions taken by the surgeon and nutrition team, prior to surgery, to encourage the individual’s compliance and address any individual obstacles to positive behavioral changes

Ok. Have any of you experienced that in this 6 months weight loss program that your BMI dropped below the requirement of 40 resulting in denial of coverage for the procedure? At this time, because I don't know if PCOS and untreated borderline high cholesterol counts as co-morbidities, I want to see if the drop below 40 will derail my efforts. Thanks you all for any help in advance!!!!