preo op requirements

[karmaandkismet 0]

I'm in the process of doing my "paper chase" and consults right now. I did weight watchers last summer for three months and even though I have documentation of my week to week weight loss at the time, it wasn't under a doctor's supervision so I know I will have to do the 3 month supervised diet before I have the surgery. My question is, when you do the 3 month supervised diet, do the insurance companies require that you complete the entire three months before they approve you, or do you get your approval while you are doing your three month diet and then they schedule your surgery for when your three months is completed?

[Nean4488 1]

Your doctor wont even submit your paper work to the insurance company until your 3 month diet is over.

[AnneGG 0]

I think this would depend on your particular Dr's office.

[Bklynike 0]

My insurance company will not pay for any part of the surgery - there is an exclusion clause, so consider yourself lucky you only have to wait 3 months before sending in the paperwork. Perhaps your doc can manipulate the dates since he is aware of your situation and if you have been under his care for any part of the diet... Good luck.

[Nean4488 1]

it goes by really quickly. You an check out my dates in my sig.

[karmaandkismet 0]

Nean4488,

I see you started your diet on 1/26 and had your approval 4/16 which is actually 10 days shy of the 3 month mark, so that's why I wondered if they actually turn your paperwork in while you're on the diet since yours was approved so quickly.

I don't mind the 3 month wait. It will actually give me time to earn more paid time off for the surgery so if I need longer (I've talked to a couple of nurses who work 12 hour shifts and they had to wait at least 2 weeks before going back to work) then I'll have it.

We have our vacation planned for next month and have a wedding this summer as well, so having the surgery after that time period would actually be preferable.

[Nean4488 1]

THe way my doctors office did it was really weird. As long as I went to visit the doctor and record my weight 3 times in different months it counted. so say I went at the end of january, i could go at the start of feb and it still counted. I didnt have to wait a whole month inbetween my visits. I have a very hetic work and school life so thats why i didnt take full advantage of that. But im pretty sure the insurance company needs to see you finished that diet before they will even approve you.

[jdonnajay 0]

how do you respond to these posts,..i have summitted ones but cant figure out how to respond..thank you

[Katy517 1]

Just click the 'quote' button in the post you want to respond to and then edit the original post if you want to as I have done in your post below. Type your response and then click the 'submit reply' button.

how do you respond...i have summitted ones but cant figure out how to respond..

[ftodd30263 0]

I'm in the process of doing my "paper chase" and consults right now. I did weight watchers last summer for three months and even though I have documentation of my week to week weight loss at the time, it wasn't under a doctor's supervision so I know I will have to do the 3 month supervised diet before I have the surgery. My question is, when you do the 3 month supervised diet, do the insurance companies require that you complete the entire three months before they approve you, or do you get your approval while you are doing your three month diet and then they schedule your surgery for when your three months is completed?

You are very lucky to only have to wait 3 months, I have to wait 6 months for my insurance company to approve me. Good luck with everything.:smile:

[Cocoabean 430]

I appealed my insurance co's 6 month requirement with WW's records and won the appeal. I could not even see the surgeon without completing a 6 month program.

I won the appeal and got the consult. It still took over 6 months to get my surgery with all the other tests and things, but at least I didn't have to wait that much longer.

Good luck!

[BetsyB 9]

My insurance company gave conditional approval; I knew that if I completed my doctor's supervision, approval was forthcoming.

(I, too, had documented WW attendance, as well as documented supervision by my PCP; the "official" supervision did not begin until I stepped on the bariatric surgeon's scale.)

The three months went by FAST---there is lots of other stuff crammed in there, so you'll be busy as you "wait." (It's a really great time to focus on behaviors you'll need postop, too :thumbup:)

[MelJ113074 0]

THe way my doctors office did it was really weird. As long as I went to visit the doctor and record my weight 3 times in different months it counted. so say I went at the end of january, i could go at the start of feb and it still counted. I didnt have to wait a whole month inbetween my visits. I have a very hetic work and school life so thats why i didnt take full advantage of that. But im pretty sure the insurance company needs to see you finished that diet before they will even approve you.

HOLY CROW!!!! That can be considered a 3 month diet!!!!! :thumbup::thumbup: They've weighed me in March and April, but my PCP weighed me in Feb and they have those results. Is it possible that's why my insurance company never asked me for it. Maybe I met those requirements and didn't even know it. This suspense is KILLING me!

[CurvyCat 0]

I think it just depends on your insurance company. I thought my 3-month diet would finish in time for me to get a surgery date at the end of March. Turns out that my 3-month requirement was actually a 90-day requirement, so I couldn't even submit until after April 6. So, for me, that means a surgery date in June, as I wanted to do it when I knew I wasn't going to be travelling during the post-op liquid/mushy stages.

Nean is right, though, it goes by really fast -- and if you can buckle down during those 3 months, you can really make a dent in what you'll have to take off post-op. I can't maintain the indefinite self-control needed to get all this weight off, but I sure can do it for a few months when I know there's a light at the end of the tunnel -- a short-term sprint is way easier than the marathon! :thumbup:

[karmaandkismet 0]

I'm actually cool with having to wait the three months. It gives my husband more time to warm up to all this and it gives me more time to earn more paid off for the surgery. I'm an RN that works busy 12 hour shifts and from what I understand, you're not supposed to lift anything heavier than 10 pounds for about 4 weeks and its pretty ludicrous to think that I won't be lifting anything heavier than 10 pounds at work. It gives me time to plan for my future, start to make some of the changes that I'll have to do post op, and start taking better care of myself mentally as well as physically. I've kind of been thinking of it like its an engagement... a short one. Like you've got three months to plan your wedding. I've got three months to plan for my skinny future. When you look at it like that its kinda like "Oh crap! I've only got three months!":eek: