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

Did anyone fake their 6 months supervised weight loss?



Recommended Posts

I'm not asking for myself. I have a friend who's insurance requires six months of supervised weight loss. He can't afford the copays or WW fees. He's tried to lose, I've seen it myself. Just wondering what kind of trouble he's looking at. Again, not for me! I'm legit!

Share this post


Link to post
Share on other sites

How can you fake it? Most insurance companies that require it want documentation and often that has to be verified by medical personnel . Can't he just see his GP? Cutting corners often just ends up biting you in the butt. If the copays are an issue he should let his doctor know.

Share this post


Link to post
Share on other sites

WW wasn't even allowed for my 3 months diet. I just checked in with my dietitian 3 times. Yeah I'm not sure how he could "fake" anything unless he's typing up his own fake documents and in that case yes you could get in some serious trouble falsifying medical documents. Better just save up the money and do it the honest way.

Share this post


Link to post
Share on other sites

Even if he did WW, he's still required to see his doctor monthly. The insurance will most likely want clinical notes. So it's not really possible to fake it.

Share this post


Link to post
Share on other sites

"Faking" anything is not a great way to start out this serious life-changing decision. He's only cheating himself and his health. His long-term success at WLS would be very unlikely with that attitude...

Share this post


Link to post
Share on other sites

How can he afford the surgery, but not WW or copays? ????

Share this post


Link to post
Share on other sites

I had a 6 month stipulation on my insurance as well, but they HAD to be with a doctor or registered dietician. Also I am curious like the others, how is he paying surgery but not copays? He may want to rethink that plan. This is coming from someone who got a nice surprise $18000 bill from the hospital after surgery.

Share this post


Link to post
Share on other sites

The only way I could see someone faking the six months is by falsifying the documentation and that's fraud which is a serious crime. I would hope that's not what has happened.

Share this post


Link to post
Share on other sites

My doctor had a thorough history of my decades long struggles with my weight (e.g. past significant loss via WW, followed by regain+, etc.). He had a good sense of all that I had and was currently trying to lose weight. He then provided a plan that made it possible to do the 6 months without making me crazy or broke.

I met with the nutritionist at his practice 1x. One co-pay.

I went to my doctor's office for monthly weigh-ins for 6 months. Most of those visits I did not see him, thus no co-pay. He treats many bariatric patients and has instructed his registration staff and medical assts. to register us w/o co-pay and just weigh us.

When I did have true visits, he always interviewed me about what I was doing, but I never provided "proof". Good luck to your friend!

Share this post


Link to post
Share on other sites

I have not had my surgery yet, however with all the information I have read, people I have talked to, information sessions I have attended and my list could go on...WHY would anyone even consider this? I may have fudged a pound or two to myself, but visiting with my PCP told the truth, and we worked from there. If anyone is considering "faking" information, not only are they breaking the law, but they are walking the failure path. This surgery and me is more important that faking something to obtain a REAL goal.

Share this post


Link to post
Share on other sites

I can't imagine how you can fake it. The insurance company wants to see that straight from the doctor (my doctor's office submitted all that stuff for me).

And they also worked with me on the payments. As long as you have insurance that will cover the surgery (which your surgeon's office will look into for you) I can't imagine what the problem would be.

And, there are going to be tons of other expenses anyhow for all the tests you have to get done before.

So I find it an odd query frankly.

Share this post


Link to post
Share on other sites

It has to be verified by the physician that the patient met with the Dr every month for 6 months, without fail. So, no way to fake it. And why would your friend want to? It's really a part of the process that is "necessary", and truly, the wait seemed long, but it really wasn't. As I look back, I regret nothing. Me being a rule follower is something the Psych honed in on, and made me a perfect candidate for the surgery. A cheater will likely fail, just my 2 cents.

Share this post


Link to post
Share on other sites

Thanks. His insurance is covering the surgery 100% (jealous). They said he only needs WE or Jenny Craig. I'll give him feed back. I told him it sounded dangerous.

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

    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 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

    ×