Medically Supervised Diet

[chubsy 1]

HI fellow bandsters to be. I have a question. The medicaly supervised diet that almost all insurances require, is this to be supervised by the surgeons office that will do the surgery or your family doctor? Also, who submits paperwork to insurance, ur fam doc or surgeon? Not sure about all that. I was under the impression that once u go see a surgeon that they take u under the wing and work on everything. Am i wrong? Any help would be appreciated.

[Maddysgram 6,159]

Yes, it is your PCP who handles the diet part and turns everything over to surgeon and they send it in. At least in my case it works that way.

[chubsy 1]

Thank you. Should i even go see a surgeon before i do the diet?

[KC215 2]

Your PCP will do the documentation. My surgeon sent a form for them to fill out after I completed it. I'm not sure what your doctor's procedure for that would be but you should definitely make an appointment with your surgeon for a consultation and they will let you know what you need to do. My surgeon's office walked me through every step of the way! Good luck

[Sojourner 2,446]

HI fellow bandsters to be. I have a question. The medicaly supervised diet that almost all insurances require, is this to be supervised by the surgeons office that will do the surgery or your family doctor? Also, who submits paperwork to insurance, ur fam doc or surgeon? Not sure about all that. I was under the impression that once u go see a surgeon that they take u under the wing and work on everything. Am i wrong? Any help would be appreciated.

My PCP supervised my required 6 month medically supervised diet, submitted the required letter of medical necessity to my insurance company, and then I was notified by my insurance company of their decision (first letter approval).

I then notified my surgeon's office, and his medical staff and insurance specialist took over from that point.

[chubsy 1]

Thank you. If its not too much too ask. Could you please explain what you needed to do during those six months? Is the diet prescribed by the doctor? Or is it just writing down what you eat? Are you expected to loose weight during that time? Is it good or bad, regarding the insurance approval, if you loose weight during that period? So many questions so sorry

[SoccerMomma73 1,867]

Thank you. If its not too much too ask. Could you please explain what you needed to do during those six months? Is the diet prescribed by the doctor? Or is it just writing down what you eat? Are you expected to loose weight during that time? Is it good or bad' date=' regarding the insurance approval, if you loose weight during that period? So many questions so sorry[/quote']

I'm a family practice physician assistant and we deal with this a lot. For the most part it is documenting that you were seen in a monthly basis and you and your PCP discussed healthy diet and exercise. I expect my patients to log all intake and physical activity and I give them something written to take home (either information on diet, exercise, or both) at each visit. My documentation states that patient was seen for weight loss counseling, healthy lifestyle including diet and exercise was discussed, patient is to follow-up in 30 days with food and activity log and will focus on making xxx changes during that time. XXX is typically increasing physical activity, decreasing calorie dense/nutrient low foods, preparing more meals at home and less eating out and pre packaged foods, increasing fresh fruits and vegetables in diet and decreasing highly refined carbohydrate intake, or focusing on a low carbohydrate, high lean Protein diet. There are a few odd insurances that do require weight loss but they are few and far between. Your surgeon hopefully will know which company's those are. Honestly, it's more of a formality than anything. Once every 5 or 6 years I will have someone who does everything I say and loses a ton of weight, most lose a few pounds but I do gripe if they gain a bunch!!!

[Maddysgram 6,159]

My bariatric Center handles everything, even though PCP handles diet.

[chubsy 1]

Thank you all so much.

I have CIGNA and i am not sure what they require so i will call them tomorrow so i can get the ball rollin. I hope its only 3 months. 6 is just too ling but if i have to i will do it no excueses

[SoccerMomma73 1,867]

If it makes you feel any better, I have to wait 6 months til my revision, no doctors appointments, no teting, no classes, nothing to check off a list, just wait. My next doc appointment is in early February! Sounds Cray but I almost wish I had a meeting or something in between to make more of a short term goal!

[Jim1967 3,569]

Thank you all so much.

I have CIGNA and i am not sure what they require so i will call them tomorrow so i can get the ball rollin. I hope its only 3 months. 6 is just too ling but if i have to i will do it no excueses

I have Cigna and had to do 6 months but recently I heard they changed that requirement to 3 months. I go to a center of excellence and my surgeons staff handled everything. I didn't have to see a doctor or nurse for weigh ins every month. I had to go to the center step on a scale in the waiting room and they recorded my weight and I left. Did that for 6 months. Saw a Nutritionist there at the center twice. They took my food logs and they documented everything and faxed it over to Cigna. I was approved in 4 days.

Good Luck!!

[SoccerMomma73 1,867]

I think, the supervised weight loss is on its way out as part of the criteria....it may remain for someone who has no documentation of a lifetime of obesity, but I think over the next few years you'll see it disappear as a requirement and be replaced with something like you have to show a several year history of obesity, and if you've seen a doc one or twice a year and they've documented your weight, it'll count....at leat I hope that's where we are headed.

[prettysmart1913 48]

Every insurance company and surgeon requires something different. My insurance required 12 months but I was already 9 months in when I decided on a band. I didn't do the 9 to get the band. I also had to have 30 days of a dietician supervised diet and participation in UHC obesity counseling program that my company requires for reduced premiums. It sounds like a lot but it really was best because I did all of that just because I wanted to lose. I only decided on the band after a friend revealed that is how she lost all of her weight.

[chubsy 1]

Just ti update. I checked with my insurance (CIGNA) and my plan covers the bariatric surgery and all post op follow ups! This is great news. 100% coverage in network and 80% out of network. I have already scheduled two seminars and one appointment with the surgeon. Being that live in NYC i have an option between two of the best in the business. As far as supervised diet goes CIGNA only requires 3 months! Great news again! I am getting so excited about the whole process but the surgeons are so busy that my first apt. Is in mid september. I wanna do this tomorrow if i could and get started in my success story! Lol...godd luck to all of us!