Understanding my 6 month preop diet insurance requirements?

[Mhy12784 423]

I have empire BCBS insurance and this is one of the requirements

"The individual must have serially documented active participation in a non-surgical weight reduction regimen for at least 6 continuous months, in the 2 years prior to surgery, to enable both behavioral changes and adequate assessment of anticipated postoperative dietary maintenance. These efforts must be fully appraised and documented by the physician requesting authorization for surgery; "

Does this mean I need to have followed a diet plan from my physician ? Or I could have done my own thing, and simply had it appraised and documented by my surgeon ?

IE could I just have journal-ed my own diet plan that I followed, bring it into my surgeon say here you was this good, and have him sign the box ?

[blizair09 3,250]

Most insurance companies that have such requirements require a ton of paperwork that documents every step of that six month journey. Either check with your insurance yourself, or get the process started with a surgeon in your network. His staff will explore the exact requirements and communicate those to you on the first of the six monthly visits.

I lost 99 pounds during my six month program. It was one of the best parts of this journey for me.

Good luck!

[LeaninLanc 83]

I have BCBS of Minnesota and the policy didn't leave much wiggle room. I had to make six monthly visits to a certified nurse practitioner at the surgeon's office with monthly weights documented. I had to keep a daily calorie, weight and exercise log. It was frustrating but worth it in the end.

[Mhy12784 423]

Was that stated in the policy or did the plan say something like a surgeon directed plan , or was your policy worded similarly to mine?

I'm purely just interpretating the vague wordedness of my own plan

[LeaninLanc 83]

I believe it spelled out physician supervised. I called the BCBS office and had them email me all their Bariatric surgery requirements. I had hoped to use some weight watcher records but that wouldn't fly as I hadn't seen a doctor or CNP monthly to monitor. I'm sure a representative at BCBS can clarify for you.

Edited July 6, 2017 by LeaninLanc
Spelling error

[Little Green 582]

1 hour ago, Mhy12784 said:

Was that stated in the policy or did the plan say something like a surgeon directed plan , or was your policy worded similarly to mine?

I'm purely just interpretating the vague wordedness of my own plan

I would give them a call or send them a message through your insurance portal if they have that. They will usually clarify for you in everyday language.

[EnlightenedKristal 6]

I have BCBS Alabama and mine was 6 consecutive months with my PCP. I went in every month and saw the nurse to get weighed and discuss my diet and exercise plan they made notes on a form they have which was in turn reviewed, signed by PCP, and submitted to the insurance company. I also had to include an office note for the previous 3 years documenting my weight.

Hope that helps.