My insurance does cover the surgery. But, they require documentation that more conventional methods haven't worked. First, if more conventional methods did work, then I wouldn't be in this situation. Second, I haven't been on a doctor guided plan per say because all my doctor has said is that I need to lose the weight and has given me copies of diets. But, he hasn't followed me through them. They will also accept something structured like Weight Watchers or something. The only things I've been through is Men's Health Personal Trainer / Ab Diet and The Biggest Loser Club. And, I don't know if they would count them or if I can even get documentation from them stating I paid them for their services. Does anyone have any suggestions on how to get around this or do I need to tell the doctor he needs to monitor me closely for 6 months and then if it doesn't work, then try the surgery. I see him in the morning. Here is how it reads:
1. There must be documentation of medical evaluations with a history of medical / dietary therapy failures (e.g., low calorie diet, increased physical activity, and behavioral reinforcement). The provider must submit the following:
Evidence that the attempt at conservative management was within two (2) years prior to the planned surgery. An attending physician, who is managing the care and weight loss of the individual, recommends the bariatric surgery and documents the failure of conservative management. This physician must be someone other than the operating surgeon and his / her associates.
