Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Need Some Advice Please Help!!!!!



Recommended Posts

Does insurance companies approve weight watchers for the 6 month weight loss program that is required? I was denied on yesterday because they stated the weight loss physician does not have enough information about my progress and he only summarized my progress.I tried to get my physician to understand that they need progress sheets each time I made a visit,but he insisted his way was the right way really just brushing me off.Not to mention,the bariatric office I attend forgot to send my psych evaluation. I started over seeing this WLS physician and have been going the last three months,because I felt like his summary and yearly documentation wasn't going to work.My problem now is I can go three more months and have 6 consecutive month with the same ole sorry documentation and may still be denied,or I can start weight watchers on Tuesday for six months so I can have accurate documentation and get approved. PLEASE HELP

Share this post


Link to post
Share on other sites

I just copied my weight tracker from Weight Watchers and it was never questioned.

Share this post


Link to post
Share on other sites

I was told Weight Watchrs was not ok for my insurance.

I had to see a MD for 6 months.

Share this post


Link to post
Share on other sites

My insurance required a 6 month medically supervised diet, and only a physician is able to submit the letter of medical necessity for the surgery approval.

Weight Watchers, while an excellent program, does not provide the medical oversight necessary for many insurance companies to approve the surgery. Using the accurate documentation from Weight Watchers should be a good source of information to augment the information submitted by your physician. Perhaps both sets of documentation can be submitted together...just a thought!

Share this post


Link to post
Share on other sites

Make sure you include the WW but also ask your surgeons office if they have any forms that could be sent to your pcp to fill out about each of your visits. This same thing happened to me. I feel the WW helped, I also wrote a personal letter and copied pictures from an overweight child to the present.

The form my surgeon sent to the PCP had the following:

Visit date

Month ___ of 6

Name

DOB

Weight

Height

BP, pulse, temp, glucose if diabetic

Weight loss meds tried in past

Weight loss meds not appropriate due to

Obesity related co-mobidities

Current medications

Diet education discussed

Exercise/activity discussed

Behavior modification goals set with patient

Return visit scheduled for

Signature , date

My PCP filled this out after my 6 months because the insurance company called my surgeon and said if they didn't get better PCP documentation they would deny it, took 24 hours to get this paper work back to them and 2 hours later I got my approval

Good Luck! It will happen!

Share this post


Link to post
Share on other sites

Forgot up at top with WL meds is the number and type of weight loss programs tried on your own.. Ie, WW, Jenny Craig, slim fast etc....

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×