Supervised diet for insurance

[batiircabur 25]

Hi Everyone,

I am just starting my jouney with Lap band. I went to the seminar and have made an appointment with my surgeon for December to start his 4 week program. In the meantime, I have to have 6 months (4 visits min) supervised physician diet/weight/BMI documented visits. My question is did you find someone special to go to (like a weight loss clinic that measures you, weighs, gives you supplements and such) or did you go to your primary doctor? If you went to your primary doctor do they honestly know what they have to do? My appointment is today and I really hope I'm doing the right thing. I would hate to go 6 months and it be something that was not done correctly. I have Avmed insurance if that helps your answers. Thanks!

[Mscaramel38 5]

You should go to your PCP for supervised weight loss visits if your surgeon does not do them. The reason I suggest this is because your PCP needs to clear you for surgery and you should make him or her aware of your weight loss plans.

[Cindy C 150]

Go to your PCP. Mine was able to bypass the 6 month diet for me. Not sure what he had to do, just know that I had surgery 25 days after beginning the process.

[batiircabur 25]

WOW, that is incredible. I dont see my PCP that often but hopefully that is something he could do as well. I wont hold my breathe, If i have to do the 6 months so be it. Its worth the "weight".

Thanks for the comments so far. I am keeping my PCP appointment for today and not bothering with the Weight Loss clinic idea.

Go to your PCP. Mine was able to bypass the 6 month diet for me. Not sure what he had to do, just know that I had surgery 25 days after beginning the process.

[ROTJob 1]

Do specifically what the insurance requires. Mine required a certified nutritionist. If I had gone to my PCP for this, I would have been denied for surgery.

[Timoniumroady 10]

Yes I agree, do exactly what the doctor says. My insurance made me do supervised weightloss for 6 months. I feel very fortunate, he had a nutritionist right in his office. Don't worry too much, your date might seem far away, but it's right around the corner. Best of luck!

[54Shirley 105]

Your PCP sees a lot of people that are on supervised diets.

They know the Pros and Cons.

If you have to do 6 months of supervised diet. (I DID 12) Get yourself a folder with pockets. Every time you go to the Dr., make sure you get weighed. That's the point. When you are done, get a printout of the visit, and put it in the folder.

Wherever you go for testing, take that folder, and tell them you need the printout. They will do it for you.

When your done, copy everything for yourself, and keep it in a folder.

When you go in to see your Dr. for the surgery, and they want proof that you were going to the Dr.. You can hand it all over to them, then they can turn the paperwork over to the Ins. Company.

It's that easy, and professional.

Shirley.

[on the way to the new me 18]

My Surgeron told me to go to a nutritionist. I need to go to a min of 3 over a 90 period with my insurance. My nutritionist just told me to follow weight watchers which i have been on since July 1st.

[honk 780]

If you belong to a gym they should also be able to print out all your visits for the last year. I submitted mine as proof of my dedication to a life change.

[batiircabur 25]

I decided to go to my PCP. He seen me this past Monday and will continue for the 6 months. My surgeons office said to start their 4 week program in December so that way everything will be completed, requirement wise, by my last visit to PCP in February and they will submit to my insurance on March 1st. My PCP wasnt very enthusiastic, it was sort of just a bunch of writing he didnt really give me any advise of any kind so it was a little discouraging. Kind of made me feel like I wasnt going to take the 6 month seriously so he wasnt either. My next visit I'm going to make sure to let him know I am serious and would like his support in this matter, support is one thing I lack and it would be nice to have it from someone like him.

All in all I'm getting anxious and I'm only 1 visit in. I'm trying to eat better and I started walking around my neighborhood this week. Thanks for the great advise I'm really glad I stumbled upon this site.

[glowormvl 4]

So is the supervised diet for insurance supposed to show the insurance company you are serious about losing weight or just that you have been trying and its not working? Also my insurance company wouldnt cover it due to my employment not authorizing that as a covered benefit so I just decided to self pay. Is there some steps i should take in order to get them to reimburse me or if its not covered its just not covered?

I decided to go to my PCP. He seen me this past Monday and will continue for the 6 months. My surgeons office said to start their 4 week program in December so that way everything will be completed, requirement wise, by my last visit to PCP in February and they will submit to my insurance on March 1st. My PCP wasnt very enthusiastic, it was sort of just a bunch of writing he didnt really give me any advise of any kind so it was a little discouraging. Kind of made me feel like I wasnt going to take the 6 month seriously so he wasnt either. My next visit I'm going to make sure to let him know I am serious and would like his support in this matter, support is one thing I lack and it would be nice to have it from someone like him.

All in all I'm getting anxious and I'm only 1 visit in. I'm trying to eat better and I started walking around my neighborhood this week. Thanks for the great advise I'm really glad I stumbled upon this site.

[batiircabur 25]

It is a requirement for my insurance company, each one is different, although I've heard a lot of people doing the 6 month physician supervised diet. My doctor said its basically to show the insurance that I am trying and that he is documenting my efforts. I have to have a physiological evaluation as well for my insurance. Regarding your other questions I'm afraid if its not covered its just not covered. When I went to the LapBand seminar they went over the payment options and its states if your insurance doesn't cover it; its out of pocket, however, they did give lots of options on payment methods. You could look into if your surgeon offers a payment plan or any other advise on any other payment options. Good luck!

So is the supervised diet for insurance supposed to show the insurance company you are serious about losing weight or just that you have been trying and its not working? Also my insurance company wouldnt cover it due to my employment not authorizing that as a covered benefit so I just decided to self pay. Is there some steps i should take in order to get them to reimburse me or if its not covered its just not covered?

[Texasbandit 8]

I don't know what state you are in but I'm in Texas and went thru true results. They do everything. I have united healthcare and they require a psych evalv, 6 months of nutrition and monitoring and certain BMI. I saw a nutritionist once and every appt I had at true results was counted towards my nutritional visit. I was weighed at every appt and asked what I ate and if I was working out. That's it! My PCP faxed a letter of recommendation to true results and they sent everything to the insurance company. I was approved in a week.

[batiircabur 25]

I live in Florida and have AvMed. I have to do 6 months of physician document diet/exercise (basically i do this on my own go back and tell him how i did and he writes it down). Then they weigh me and that's it from PCP. I have to do a physiological evaluation as well but not a nutritionist visit. I will however meet with one when I start my surgeons 4 week program. Its 4 weeks of meeting with the surgeon, nutritionist, and video and questionnaire. Its $525 out of pocket expense.

I don't know what state you are in but I'm in Texas and went thru true results. They do everything. I have united healthcare and they require a psych evalv, 6 months of nutrition and monitoring and certain BMI. I saw a nutritionist once and every appt I had at true results was counted towards my nutritional visit. I was weighed at every appt and asked what I ate and if I was working out. That's it! My PCP faxed a letter of recommendation to true results and they sent everything to the insurance company. I was approved in a week.

[Texasbandit 8]

I've been trying to get a lapband since 2008!! I started in nov 2008 and had 2 appts then in Jan my company decided to change insurance carriers and the new ones they added didn't pay for any bariatric surgeries. I was so frustrated!! Then just this year my company changed back to united healthcare. I started my appts in feburary this year.