FYI - Supervised diet visits MUST be consecutive

[Little Green 583]

Found out the hard way that for all insurance companies your appointments must be in consecutive months, or else you have to start over from month 1.

Um, whoops! I have a specific timeframe for my surgery because I am a student. So, I knew when I started my diet visits in March that I did not want to have surgery right at the end of them (August) as I wanted to wait until the semester was over. So I'm looking at December or early January. The surgeon's office said I could just do my appointments and then get approved, but not schedule the surgery until the time I needed. Great!

Unfortunately the last two months I had to reschedule my appointments several times and after multiple scheduling issues I ended up canceling both of them. (Causes were my husband's surgery and unexpectedly painful recovery, my own extreme sickness with double ear infection and bronchitis, plus separate health crises of two family members which necessitated travel.) I would have tried much harder to just make the appointments work as best I could had I known that I would have to start all over!

It's not a huge deal for me as this puts my last diet visit in December which is right on schedule, but I would hate for it to affect anyone else. SO - do NOT miss appointments!

-Annie

[KateBruin 344]

My surgeon stressed this at my consult but he told me I could see my GP or him and that seeing both would just be a waste of money. That's shitty of your surgeon's office to drop the ball or not emphasize that you need to see someone every single month.

Actually, (vodka brain talking, sorry) did you complete all of your required months then not see anyone after? Or was it 2 months during the 6 months or whatever your requirement is?

[Little Green 583]

18 minutes ago, KateBruin said:

My surgeon stressed this at my consult but he told me I could see my GP or him and that seeing both would just be a waste of money. That's shitty of your surgeon's office to drop the ball or not emphasize that you need to see someone every single month.

Actually, (vodka brain talking, sorry) did you complete all of your required months then not see anyone after? Or was it 2 months during the 6 months or whatever your requirement is?

LOL at vodka brain! No worries, I think I wasn't clear. I had done 2 out of my 6 visits but I missed the third in May, and then ended up missing the fourth one in June. (I wish I had known that missing the May one was a dealbreaker and I wouldn't have stressed so much over missing the June one too!) So now, what would have been my 3rd diet visit (or 5th if I hadn't missed) on July 13 will now be my first.

I thought about that too, about someone letting me know. I guess I can see it both ways - it's on me to show up every month and really it's a sign that you're dedicated and ready for surgery. But, things do happen like in my case so it would have been nice to know. I'm not really upset but I can imagine had my situation with the timing been different, I would have been - so I wanted to warn others. I hope most people are like you and their surgeons emphasize this!

[KateBruin 344]

Oh ya. My doctor made that clear. My insurance only requires 3 months so I literally saw him for my consult/month 1, then my GP for blood work and clearance/month 2, and surgeon for pre-op/month three. Surgery is the 31st. I only met with my dietician once and very quickly but I think they basically considered me already compliant because I eat an 80% good diet and do hardcore workouts. Not everyone needs closely monitored weight loss once the dietician gives general meal plans.

I never drink but I'm on vacation and discovered vodka is zero carb [emoji15].

[RickM 1,753]

It depends heavily on just how the insurance company's policy bulletin is worded - that is the legal gospel. Mine was for the typical 6 month physician supervised diet/exercise program that implied but did not specifically specify monthly visits. Monthly was our intent but due the the usual scheduling issues between my PCP and myself it wound up only being four visits over the six months, but that was no issue with getting approval. It's a great, big YMMV thing, but you need to do whatever their policy specifically states (that's what's legally enforceable as they wrote the rules, and that's what the regulators and courts follow.)

[Little Green 583]

23 hours ago, RickM said:

It depends heavily on just how the insurance company's policy bulletin is worded - that is the legal gospel. Mine was for the typical 6 month physician supervised diet/exercise program that implied but did not specifically specify monthly visits. Monthly was our intent but due the the usual scheduling issues between my PCP and myself it wound up only being four visits over the six months, but that was no issue with getting approval. It's a great, big YMMV thing, but you need to do whatever their policy specifically states (that's what's legally enforceable as they wrote the rules, and that's what the regulators and courts follow.)

I'm glad you said that! The voicemail my coordinator left me said "all insurance plans across the board" -- maybe he just meant the ones they are in-network for, not sure. Definitely good advice about following the individual policy to the letter!