Hi Everyone,

This is my first time posting but I have been following this forum for a few months. After much deliberation (and years of obesity), I have decided that I would like to pursue the option of weigh loss surgery. Last week, at my PCP's office, he said that he would submitt me for insurance approval of the lap band. I am currently 5'3 and weigh 272 lbs. I have been overweight all my life but over 200 lbs. the last 5 years. I am elated that my doctor is supportive and would like to see me have the procedure however I feel overwhelmed by the documentations he is requesting.I received a letter from my PCP today that says this:

The following documentation must be provided for the referral to be considered:

1.Results of previous physician supervised weigh loss program implemented in cooperation with dieticians and/or nutritionist. (Must be at least six months or longer in dutation, within the last 2 years).

2. All documentation of weigh loss programs within the last six months.

3. Six-month log or journal (must be in progress notes format). Diet type and duration. Exercise type, frequency and duration.

4.Documentated weight loss to date within the last 6 months.

I'm worried because the only medically monitored weigh loss attempt I have had has been the use of a prescription weigh loss medication 6 months ago by my primary doctor which only helped me lose 2 lbs. I have tried every diet and diet pill imaginable but don't have any documentation to prove it because it was not under the supervision of a doctor or by prescription.

How can I prove that I have attempted to lose weight ALL MY LIFE?? I am so desperate for this operation but now I feel hopeless. Can somebody please give me advice, or clarify what I am expected to "document"? Maybe provide me with a sample of what has been proven to be a successful letter of documentation where an insurance company actually approved?

Please help, anyone...I don't know what to do... :think

Thank you VERY much for taking the time to read this and I hope that somebody responds.

Chin Up Girlie!

Here is what I know...my GP signed off on the attempts that I had made over the years to lose weight. For example, Atkins, Redux, Slimfast on and on and on. I was a self pay however, so that is a different animal all together, but you still have to prove that this wasn't just a whim and that you had been in the past and would be again, serious about losing weight. I think that if your GP knows you, they should be able to help you out in the process of proving your weight loss attempts. I mean really, these insurance companys must be daft if they just think that we sit and don't try to change, they just want to be thorough. I say do whatever they are requesting now...just like the last post, just incase its the only way. Good Luck.

POPT

Tracey

Many doctors and just about all insurance companies have this six-month requirement of supervised attempt at weight loss. You can't invent it if it's not there, so get started now! As for the other attempts, what I did was make a chart to the best of my memory with the date, my weight at the start, the type of diet, how long I was on it, and my weight at the end. I had about 10 different attempts on this list, starting with WW at age 8 and weight-loss camp at age 10. Obviously I had to estimate or even guess at the weights and details for a lot of it, but when I was done it was impressive (depressing?).

So tell you doc you want to start now on the 6 month supervised diet, he'll supervise and take notes each time you visit (at least once a month, better to be every two weeks or even every week). When the six months is up you'll have all the information you need to proceed.

I had started my lapband process a year ago this month. My insurance company required the 6 months of physician supervised diet, so I had to do that first. Fortunately, my doctor just had me come in and weigh once a month, and the first two months, he had me bring in a food journal, which he told me just to make up. I actually gained 5 lbs during that 6 months...but the insurance company approved the surgery and even paid at 100%.

It may feel like a step back if you have to do that, but just remember that the band is for the rest of your life, so 6 months is nothing.

This is what I did First I saw my surgeon who was going to do the Band. There I was weighed in "very important" next month I saw my pcp, told him my surgeon put me on a 1200 calorie a day diet to loose weight. Again I was weighed in. I lost weight, and saw a Dr. the next month, might have been shrink, but I was weighed in. That's my pointe Weigh in's, there is no escapeing this. I had to go for 12 months though. Think I saw my pcp 5 or 6 times. Every month was a specialist, weight's. After each visit to a Dr. I told them to give me a print out for the vist, they did, and I had a special folder that I kept everything in. I don't care if you go for blood work! Get weighed!!! When 12 months was comeing up, I gave the nurse the folder

she coppied it. Noted that I had lost 125Lbs., and bcbs pd. for the whole thing.

So 6 months is better then 12, and you have a chance to get all your testing done at the same time they weigh you in. Your killing 2 birds with 1 stone. I no you want to have this done! so did I, but it really worked out great, and they can't get out of it. Just remember You must have 1 weight for every month in a row. If you loose it or miss 1 date they can make you start again, that depends on your ins.. get back if I can help

Shirley...:clap2: