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Help!

I saw my primary care provider in February of this year. At that visit I spoke with her specifically about needing a referral to a surgeon to begin the bariatric surgery process. One month later I went to see that surgeon and started that process. In April I started seeing my primary care provider because I found out I had a six-month Insurance requirement. Now I'm wondering can I begin the six-month in February when I first saw my provider or do I have to wait until the April visit? Anyone have any thoughts on this?

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It depends on your requirements. I had a 6 month requirement also and I had to go to my primary for 6 months of weighing in etc. It didn't start till my first appt with my primary and I had to be weighed in once a month there along with other things such as a Psych evaluation, ekg etc.......Hope this helps.

  • Author

"The patient must participate in and meet the criteria of a structured nutrition and exercise program. This includes dietitian/nutritionist consultation, low calorie diet, increased physical activity, behavioral modification, and/or pharmacologic therapy, documented in the medical record. This structured nutrition and exercise program must meet all of the following criteria: The nutrition and exercise program must be supervised and monitored by a physician working in cooperation with dieticians and/or nutritionists; and The nutrition and exercise program(s) must total 6 visits or more during a period of six consecutive months; and The nutritional and exercise program must occur within two years prior to the surgery; and The patient's participation in a structured nutrition and exercise program must be documented in the medical record by an attending physician who supervised the patient's progress. A physician's summary letter is not sufficient documentation. Documentation should include medical records of the physician's on-going assessments of the patient's progress throughout the course of the nutrition and exercise program. For patients who participate in a structured nutrition and exercise program, medical records documenting the patient's participation and progress must be available for review."

I think April is probably your starting date, because it says the visits have to be in consecutive months -- unless you started a formal diet and exercise program in February when you saw your PCP and then saw her for your next follow-up visit in March?

For me it was consecutively. Once I missed a month and had to start all over again.

  • Author

I spoke with an insurance rep and she said if the surgeon and PCP say they were both seeing me for surgical weight loss then it shouldn't be a problem. I'm just growing nervous because my surgical center is very new at this. Thanks for your experiences all!

  • 2 weeks later...
  • Author

Found out today I was approved! Thank God!

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