Weight loss documentation

jjw19697 · February 4, 2007

Does anyone know a way around the DR documented weight loss attemps of 6 or months? I have been on Jenny C, WW, Atkins, Phen-Fen, Cabbage Soup diet, you name it I have tried it, but never with a Dr's help. I currently have hypertension that is being treated w/ meds, GERD, and a BMI of 36.7. I contacted my insurance (BCBS) and I meet all criteria w/ the exception of the Dr documented weight loss attemps. I feel so frustrated.

TracyinKS · February 4, 2007

Jenny Craig and WW's should have you on their records request a copy..

I personally tracked my own weight since 2003 (after my son was born) I had weigh ins and pics of me going up and down the scale..... everyone I took it too was impressed, but in the end I didn't have to show them to the insurance.

The other thing I did was print out my reciepts from when I belonged to curves and way back when I joined ballys... (that one showed up on my credit report and dated back to 1990)

I had my ob write a letter, stating that in 2000 I was a 206 lb woman and had constantly battled my weight, infertility, misscarriage, that I had been precribed glucophage and phentermine.... and that also helped the whole documentation issue.

kathyy68 · February 4, 2007

Did your insurance specify if the attempt had to be within the last year or not? My insurance stated that my six month documentation had to be within the past 12 months. I really had given up on all the fad diets a few years ago and hadn't really tried anything. I had to do the six month diet. However, I did have over 10 years of documentation of WW, Jenny Craig, Phen/Fen, YMCA, etc. None of that helped me with the six month criteria since it wasn't within the last 12 months. I would have them clarify that for you.

Kathy

anonemouse · February 4, 2007

Jenny Craig and WW's should have you on their records request a copy..

Unfortunately, Weight Watchers throws out their records after someone hasn't been to a meeting in 6 weeks. I found that out the hard way.

I really don't think you can get around the medically supervised diet. At least, I haven't heard of any way. The only time I would think it would be possible is if your weight was seriously jeopardizing your heath and you probably wouldn't survive another 6 months without surgery.

Dustmouse · February 16, 2007

Hate to hijak this thread but I was about to post on the same subject....

My insurance specifies "Active participation within the last one to two years in one physician-directed weight-management program for a minimum of six months without any significant gaps. The weight-management program must include monthly documentation of ALL of the following:

-vital signs, including weight

-current dietary program

-physical activity

-behavioral interventions to reinforce healthy eating and exercise

-consideration of pharmocotherapy"

It goes on to state that programs like Weight Watchers and Jenny Craig alone do not meet the requirement.

I saw my PCP today and he is very supportive. I don't mind visiting him every month for six months, but the BIG QUESTION is what kind of diet am I supposed to be on??? If I go on my own diet and report to him monthly, is that enough. Should I join Weight Watchers for the fourth time and confer with him about that. Ugh, I just don't know what to do next.

Desiree1970 · February 20, 2007

My doctor has stated that I am a healthy person besides the obesity who did not visit doctors much.... This surgery is a health reason and I don't understand why insurance drags their feet so.

Candle · February 20, 2007

My insurance specifies "Active participation within the last one to two years in one physician-directed weight-management program for a minimum of six months without any significant gaps. The weight-management program must include monthly documentation of ALL of the following:

Be sure there are NO gaps at all. I've read stories from more than one person that 5 or 6 weeks went by between vistis instead of 4 and they had to start the 6 months all over again!!

I saw my PCP today and he is very supportive. I don't mind visiting him every month for six months, but the BIG QUESTION is what kind of diet am I supposed to be on??? If I go on my own diet and report to him monthly, is that enough. Should I join Weight Watchers for the fourth time and confer with him about that. Ugh, I just don't know what to do next.

I'm on month 2 of the diet and my doctor is just recording my vitals and making notes about what I am doing to lose weight. Low calorie and low carb work best for me (I have PCOS and low carb is the only way to lose weight) and recording my exercise. My surgeon has a form that she simply fills out each month and faxes to them.

RamonaL · February 24, 2007

I have a question: if your insurance company requires that you participate in a 6 month doctor-supervised plan of some sort, and you comply - let's say that you DO lose, oh I don't know, 30 lbs... and you were about 120 lbs. overweight to begin with - does anyone know if the fact that you would now "only" be 90 lbs. overweight then cause additional interference from the insurance company???

sharonking · February 26, 2007

does anyone have any experience with Medicare? I am elegible in May and have heard that it covers. Any info?

sharon

Cblancha9 · March 4, 2007

does anyone have any experience with Medicare? I am elegible in May and have heard that it covers. Any info?
sharon

Yes, I have Medicare and you have to find a hospital that is a "Center of Excellence" The one that I originally picked was appling for the COE and doesn't know when it will be approved, so I researched my area and found one about 50miles away. I'm going to the seminar at Oschners this Thursday and will let you know.

faithmd · March 4, 2007

I have a question: if your insurance company requires that you participate in a 6 month doctor-supervised plan of some sort, and you comply - let's say that you DO lose, oh I don't know, 30 lbs... and you were about 120 lbs. overweight to begin with - does anyone know if the fact that you would now "only" be 90 lbs. overweight then cause additional interference from the insurance company???

Depends, that is something you MUST ask your insurance company about. Mine said that the important weight is the weight I started the MD supervised diet at. (And my requirement is 12 months, ack!) My insurance company said that even if I lose weight on the MD diet, that is okay, they'd still approve the surgery. In fact, on the MD diet I MUST lose weight, at least 5% of my excess weight in order to prove I can follow a doctor's plan.