Six month diet requirements. ..

[hopingtolose2013 81]

Can someone please send me an example of what you had for this requirement?? My doctor didn't do six seperate notes...I think he needs an example! Thanks!

alana_macaluso@Yahoo.com

[DebDUtah 67]

I think this question is best posed to your insurance company, the utilization review department in particular. Every insurance is different, mine just required that my physician follow me for 6 months, with me visiting him 3 times with no more than 2 months between visits. It did not require any special diet (i.e. weight watchers or nutrisystem) but we talked about changes I can make or did make, and what to work on to be more successful. The success or failure is not what is important, at least that is what my insurance plan told me. Yet another co-worker who chose to be covered by BCBS requires that you also participate in weight watchers or nutri-system during that six month diet. I am glad I checked with my insurance, as I did not want to have to do the structured plans as my life after the sleeve will require me to have made changes that last the rest of my life rather than last as long as I can pay for a plan. As far as the notes we speak about the changes I have made in my life and diet to support my surgery plan and life after surgery and he is making sure I am exercising, it is a good thing. You can also check with your surgeon as to what they like to see.

[DaFierce1 71]

Hi, the 6mo requirement.. Are these visits with your pcp or the team with the surgeon?

Sent from my iPhone using VST

[chinamama 104]

Good advice to check with your insurance. Mine specifically said NO weight watchers. And balked at my nutritionist visits, for some weird reason they wanted me to see the surgeon.

[Spoiled1 15]

Here are the diets my dietician recommended...

Here you go:

8:00 am Protein Drink (Atkins Advantage)

10:00 am Yougurt (lite)

12:00 pm Protein Drink (Atkins Advantage) + ½ sandwhich (turkey,

chicken, or ham)

2:00 pm Protein Drink (Atkins Advantage)

4:00 pm ½ cup fresh fruit

7:00 pm Frozen entree (Healthy choice, weight watchers, or Lean

Cuisine) + ½ cup salad with lite dressing

48-64 oz of Water per day and exercise.

1200 Calorie meal plan

Starch

meat

Vegetable

Fruit

Milk

Fat

Breakfast

2

0

0

1

1

1

lunch

2

2

1

1

0

1

Supper

1

2

2

0

0

0

snack

0

0

0

0

1

0

Example meal plan

Breakfast:​1-2oz bagel

​1 small banana

​1 cup skim milk or 1 cup non-fat yogurt

​1 tsp margarine

Lunch:​2 oz turkey on 2 slices wheat bread

​1 tbsp “lite” Mayonnaise

​1 cup raw carrots

​1 small fresh apple

Supper:​2 oz grilled chicken breast

​1 medium baked potato (fist size)

​1 cup raw vegetable salad

​½ cup cooked green Beans

​

Snack:​​1 cup skim milk or 1 cup non-fat yogurt

[Spoiled1 15]

Those are te diets I had to follow for my 6mo supervised diet. The Protein Shake diet I just started almost a month ago and have lost about 12lbs so far...

[quackstitch 10]

has anyone done the six month required diet and then been turned down because you lost a couple pounds too much?

I'm three months into the 6-month requirement and afraid to actually lose any- i do have 4 or 5 co-morbidities but don't want

to get turned down!

[Rysgrammy45 0]

has anyone done the six month required diet and then been turned down because you lost a couple pounds too much?

I'm three months into the 6-month requirement and afraid to actually lose any- i do have 4 or 5 co-morbidities but don't want

to get turned down!

I am also wondering that too.. I've lost 12lbs, but it is the same 12lbs I lose over and over again.

[DebDUtah 67]

I checked with my insurance company actually asked "if on the 6 month supervisory diet and lose weight will I be denied?" (I am not afraid to ask them anything). They said that how great the success or how bad the failure, any outcome from the diet would not determine acceptance or denial. It had to do with BMI at the START of my supervised diet. I double checked this with my surgeon's insurance specialist and they confirmed what my insurance said. Realize No one can answer that for you only your insurance company and surgeon and realize your insurance company has the final say.

[hopingtolose2013 81]

Can i just be honest? This requirement it's the most ridiculous. Do they really think someone who has been over weight for years hasn't tried to lose weight? It would be much easier if you could just diet and not need major surgery. However we all know that isn't possible for some of us. I can lose weight. ..but i can't keep it off our go below a certain number. ..of i could i wouldn't be trying to have major surgery. Just makes me mad.

[tempname123 37]

Can someone please send me an example of what you had for this requirement?? My doctor didn't do six seperate notes...I think he needs an example! Thanks!

alana_macaluso@Yahoo.com

If your insurance is paying then they require "supervised weight loss attempt" without prescriptions. The actual goal is to lose little weight and do not gain weight. I have 2 insurances, one only requires 3 months while the other requires 6 months. Some people's don't pay at all and some require 12 months. I would strongly discourage you from contacting your insurance because they have the final say on whether or not they approve you and if you start a fire they can deny you. All they want to see is supervised weight loss attempt. Since wls is expensive they want to see you actually try under a doctors supervision to attempt to lose weight and not just get an expensive surgery they have to pay. The thing is, some people are successful with this. My cousin was. She went through all qualifications but lost so much weight seeing a nutritionist and supervised doctor visits that she lost over 60lbs and no longer qualified.

[rosita13 10]

Man and I thought my insurance was tough! I was only required to show 3 months of observed diet and exercise!!

[tempname123 37]

Can someone please send me an example of what you had for this requirement?? My doctor didn't do six seperate notes...I think he needs an example! Thanks!

alana_macaluso@Yahoo.com

Also your medical records should reflect 6 separate records of the visit, the dates and times. They should not be "notes" but rather records and clinical summaries.

[tempname123 37]

I am also wondering that too.. I've lost 12lbs' date=' but it is the same 12lbs I lose over and over again.[/quote']

It's based on BMI so watch your BMI, if it drops down to dequalifying numbers than yes it's possible. I've seen that with my own eyes.

[tempname123 37]

Can i just be honest? This requirement it's the most ridiculous. Do they really think someone who has been over weight for years hasn't tried to lose weight? It would be much easier if you could just diet and not need major surgery. However we all know that isn't possible for some of us. I can lose weight. ..but i can't keep it off our go below a certain number. ..of i could i wouldn't be trying to have major surgery. Just makes me mad.

I agree, but it's kind of one of those things. If someone else is going to shell out money for you, you got to do what they want. I go to school on 3 full ride scholarships and I have to jump through hoops all the time. It sucks, but the question is how bad do you want/need it? I get nearly $30,000 per school year (fall/spring) in scholarships. No income and tuition/fees alone cost $15k. Money I don't have. My surgery cost nearly $40,000, again money I don't have.