Ok What Does This Mean! Lol

[Jessielynn 112]

The individual must have actively participated in non-surgical methods of weight reduction; these efforts must be fully appraised by the physician requesting authorization for surgery;

Ok this is exactly what is in my plans guidelines. Does this mean I need 6 months of diet or should the diets I've used in the past be sufficient as long as my pcp describes them in the referral? I have got the referral, going in for the psych eval tomarrow, and really don't want to miss a step! I am so nervous that I've missed something.....please help.

[valdostaGA 149]

The individual must have actively participated in non-surgical methods of weight reduction; these efforts must be fully appraised by the physician requesting authorization for surgery;

Ok this is exactly what is in my plans guidielines. Does this mean I need 6 months of diet or should the diets I've used in the past be sufficient as long as my pcp describes them in the referral? I have got the referral' date=' going in for the psych eval tomarrow, and really don't want to miss a step! I am so nervous that I've missed something.....please help.

[/quote']

It sounds like u need a supervised diet by a physician, but how long I don't know. That should be in the requirements. The best thing to do is call your insurance yourself.

[FDclerical 318]

please CALL your insurance directly and ask them the requirements of cover bariatric surgery. they will be happy to help you. this way you dont miss anything at all

[Jessielynn 112]

I have twice and both times they referred me to the thread online! That is where I copied that line from! I'm so confused...lol

[FDclerical 318]

that is really crazy! hmmm well i know my surgeons office already knew the requirements SOME insurance companies require 6 months worth of dietician appointments others only require 2 or 3. it really just depends. i would post your type of insurance and state that you live in. maybe some others have the same insurance and know the requirements. i would think they would be way more helpful than directing you online.

again i would call them back and advise them that the description on the website just isnt clear. if they dont help you i know one of the nurses at your surgeons office can provide you with a clear answer (there is a department that submits your paperwork directly to the insurance for approval) and they should be able to help as well! good luck to you!!!!!

[KS Fort Worth 86]

I think they might be looking for evidence you CAN lose weight, which would show that you recognize the surgery is not a magic bullet. Someone who's weight never drops, even in the months between consultation and surgery, is not likely to succeed. Most, if not all, of us here have yo-yoed in the past, and that will show in the weight history. If you've been seeing your regular doctor for anything, they always weigh you. If they want medically supervised as well, it should say so in the insurance guidelines; Aetna's did.

[jennyblue111 32]

It sounded like my insurance wanted me to have proof of a Dr. supervised diet for 6 consecutive months no greater than 2 years away from my proposed surgery date. What it really boiled down to was a height & weight record from a physician for 6 months straight, citing that I've been fat consistently for 6 months & haven't shrunk in height. They don't care if u were actually on a diet plan or actually gained or list weight. But Weight Watchers doesn't count, it's not Dr. supervised.

Some insurances will accept dated photos of your fatness as proof of eligibility for surgery.

In short, it just depends. There was a financial coordinator @ my Dr.'s office that advocates for the patients, that helps take care of all that rigamaroo. Maybe your Dr. had someone like that that can help u since ur insurance won't. They are very familiar w/all that insurance crap. It's a shame your insurance is treating u that way. I'm sorry

[Jessielynn 112]

that is really crazy! hmmm well i know my surgeons office already knew the requirements SOME insurance companies require 6 months worth of dietician appointments others only require 2 or 3. it really just depends. i would post your type of insurance and state that you live in. maybe some others have the same insurance and know the requirements. i would think they would be way more helpful than directing you online.

again i would call them back and advise them that the description on the website just isnt clear. if they dont help you i know one of the nurses at your surgeons office can provide you with a clear answer (there is a department that submits your paperwork directly to the insurance for approval) and they should be able to help as well! good luck to you!!!!!

Thank you for your help! I know the insurance lady at my drs office is on vaca for 2 wks, and the nurses keep sending me to her voicemail! I guess I will just wait till she gets back! I don't really want to wait on anything pertaining to this, I feel if I stop doing everything, even for a day, it won't happen! Lol

[Toyaboo22 51]

My insurance says the same thing and from what my coordinator told me, it means you don't have to do a supervised diet for example the 6 month one but you have to inform your pcp of previous weight loss attempts in which they would document in their letter to the insurance company.