I have Blue Shieldnof CA and was denied authorization for bariatric consult because I don't have "documentation of a 6 month diet" Neither my PCP or my medical group or insurance company is being much help. I'm not sure if this means I have to do a physician supervised diet where I weigh in at my pcp for the next 6 months or if it's a diet I can do on my own.

The surgeon program I want to go with had me weigh in at the info session and nutrition session and I have 4 more weigh ins with them before I proceed with their program. My pcp says I don't have to weigh in with her and those weigh ins count but I don't see how that satisfies a 6 month diet if its just weigh ins. Does anyone have experience with this?

@@Chloewithac Talk to your Bariatric Program - I did my supervised diet with the Nutritionist (supervised by surgeon). I have BCBS in another state and they were not forthcoming with what the requirements were either. Your surgeon's office should be able to find out. I didn't need authorization for the Consult - just for surgery.

Do you have a PPO or an H*M*O*? Blue shied of California removed the 6-month requirement in June of 2015 for PPO plans.

I have a hmo. Also it's the authorization for the consult that I need. It's just weird because my pcp said nothing about 6 month diet and said I don't need to come in to weigh with her.

H*m*o

I have a ***. Also it's the authorization for the consult that I need. It's just weird because my pcp said nothing about 6 month diet and said I don't need to come in to weigh with her.

H*m*o

I would say your PCP is incorrect. If you need documentation of 6 months of a supervised diet before seeing the surgeon - she/he needs to be the one to do that. I would talk to the insurance coordinator at your surgeon's office and see if they can help you make sense of the requirements. Good luck!

Edited September 5, 20169 yr by KristenLe

I have CA bcbs HMO and had to do my 6 month diet/visits with my PCP to obtain the referral for the Surgeon. My first visit counted as month 1 so it's really only 5 months. I have my last visit this month. From there she will provide the referral and I will move on to the surgeon who will do the additional testing and submission for the surgery approval.