6 Month Required Physician Visits???

[MissUni 0]

MissUni do you by any chance work for omnicare? Because the same is happening with me!

bbanded, I work for Cablevision. The really poopy thing was when I got my approval letter in the mail from my OLD company on January 5th. I cried and cussed a little, but the insurance coordinator for my Doc says that the approval from the old company will only give us more ammo to send to the new company. Are you still waiting for a reply from your insurance company now or do you have approval?

[bbbanded 70]

I feel ya, I was so discouraged when I found out the new insurance didnt cover it. But the medical center I'm working with has been really helpful with getting everything going. We were told that they only cover it if its proven to be medically necessary. So my regular doctor wrote a letter saying that it was, and like you, the letter from the old insurance saying that they were going to cover is supposed to add fuel to the fire, in a good way.

I don't think we have a flat out answer as of yet, but I dont see any reason why it should be a no at this point. I'm guessing neither do they because they have me on the 2 week pre op diet.

In the end, I wouldn't worry because, no insurance company in their right mind would rather pay more than helpful surgery than for someone to have continuous doctors visits for various obesity related illnesses. Thats my input anyway.

[mags2u 57]

Mine was three months at first, so when I was on my 3rd visit (May 2011) my Weight Loss Institute called me and said my insurance requirements had changed. Devistated. Then I got pissed and said well I'll show you and didn't see my PCP for two months. Boy I really showed them didn't I. How stupid was that! The insurance requirements were changed to six months with my pcp. My last appt. with my surgeon did count though. My visits also did not have to be consecutive. My recommendation to ANYONE getting this surgery is don't let other people (your Dr.s office) do the work for you. You are the patient- CALL your insurance company. Mine faxed me the direct weight loss surgery policy so if I had any questions, I could refer to that. Every insurance company is different, so stay up on it.

[kariew28 6]

I have to do 7 consecutive weigh ins with pcp, 2 years worth of weight history, medical necessity letter from pcp, nutritionist,and psychiatric evaluation. I'm going to my 5th weigh in Feb 21. Surgeon told me don't lose any weight just maintain otherwise I would be below BMI requirements. Also, said weigh ins have to be 4-5 weeks apart...but consecutive and consistant. I'm so ready...I have tried a million different weight lose plans...I can always lose weight....but can't maintain...always gain it back plus some. Hopeing for surgery in May.

[morelgirl 177]

Good luck, Greekie. Keep an eye on what goes in, and I'm sure those 4 pounds will come off!

[lucky2bLAURA 31]

I had to do the 6 month supervised diet also... I'm halfway thru my 5th month, and I'm getting a little discouraged. Things aren't going the way I thought they would and I keep wondering if I'm even doing the right thing. At the seminar I was told that in the 5th month we would be getting all the other necessary requirements met so that it could be sent to the insurance company for approval right after the 6th weigh-in. I'm not really sure what's going on and what all I need to do and what appointments to make. It doesn't help anything that I work nights on a 12 hour compressed workshift. I know it will all work out in the end. I think I'm just getting scared because I've never had surgery, so I'm looking for things to go wrong.

[shy2012 43]

Make sure and double check with your insurance that the 6 months is indeed required because the Dr. Office I went to assumed based on my insurance that it was required but it actually was not. I called to verify with my insurance carrier and then the ofc rep called and checked and they told her it was not required. Just double check ! And get a copy of your health insurance policy. It's a lot of paper but worth it to have for proof!

[my3sons75 11]

I am in the pre-op insurance limbo right now too My insurance requires 6 months of a medically supervised nutrition plan OR 3 months of a pre-op plan thru the weight loss office - so of course I'm doing the 3 month choice. Whew, don't know if I have it in me to do this for 6 months. I'm only 4 weeks into it and have lost 8 pounds, am following a lot of the dietary recommendations, but I am hungry all the time. In my 2nd appointment today they told me to follow the recommendations as far as what and how much to eat, how to chew and so on, but when I finish my meal I can have more if I'd like. This is just to try and get me used to the process that I'm going to be living with from now on. Quick weight loss the week before the surgery is the only thing that's important to them, to reduce the liver size. The insurance companies just want to make sure they are not paying for a surgery that won't do any good if you can't change your eating habits. I know my downfall after my diets was my portion size, so I'm hoping this will be the answer for me.

I work with insurance companies thru my job and know they have strict rules on what they allow and don't allow, and if you don't follow their every requirement then they will deny. I just have to swallow my irritation and play their game.

Good luck to you all that you will be approved!