Medical Policy... Ughh!

[Bamabander 111]

I finished my 7th visit in March due to the fact I am not eligible for the sleeve (BMI<50) my office is resubmitted for the band. Got a call and I have to meet with a dietician for my insurance to be submitted... never mentioned this before (guess it's my fault for not reading the requirements) but went through the visits, increased exercise and was on Weight Watchers (documented the last 16 months). I am worried that I will be denied and have to start the 6 month supervised all over again to work with a dietician... what do you think... any tips! I am practically in tears! I am scheduled to meet with the dietician on Monday.

Here's the medical policy wording:

The patient must participate in and meet the criteria of a structured nutrition and exercise program. This includes dietitian/nutritionist consultation, low calorie diet, increased physical activity, behavioral modification, and/or pharmacologic therapy, documented in the medical record. This structured nutrition and exercise program must meet all of the following criteria:

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  The nutrition and exercise program must be supervised and monitored by a physician working in cooperation with dieticians and/or nutritionists; and
  
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  The nutrition and exercise program(s) must total 6 visits or more during a period of six consecutive months; and
  
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  The nutritional and exercise program must occur within two years prior to the surgery; and
  

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  The patient's participation in a structured nutrition and exercise program must be documented in the medical record by an attending physician who supervised the patient's progress. A physician's summary letter is not sufficient documentation. Documentation should include medical records of the physician's on-going assessments of the patient's progress throughout the course of the nutrition and exercise program. For patients who participate in a structured nutrition and exercise program, medical records documenting the patient's participation and progress must be available for review.
  

Think I will have to start from the beginning???

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