Diet Documentation

[MistyfortheMountain 119]

I went to my seminar last week and was told all my insurance required was a psych visit and a visit with a nutritionist. They scheduled me to meet with both on Nov 13th and to meet with the surgeon yesterday. My surgeon was great, told me I was a great candidate. When I asked him how long until I could actually get the surgery he checked my file and told me all I needed was a psych and nutrition visit and they were already scheduled. I should be looking at a late Nov. early Dec. surgery date. Yea! Or so I thought. Then I met with a nurse there to get informational packets for my meeting with the psych/nutritionist. She tells me that my insurance doesn't require a 6 month diet, they only need documentation of my diet attempts in the past. How am I supposed to document that? I never did weight watchers or anything. I did go to a dr for diet pills but after 5 years they destroy records. No luck there. Most of my diets were things like Atkins, calorie counting, over the counter stuff. Now what?

[DELETE THIS ACCOUNT! 12,703]

I went to my seminar last week and was told all my insurance required was a psych visit and a visit with a nutritionist. They scheduled me to meet with both on Nov 13th and to meet with the surgeon yesterday. My surgeon was great, told me I was a great candidate. When I asked him how long until I could actually get the surgery he checked my file and told me all I needed was a psych and nutrition visit and they were already scheduled. I should be looking at a late Nov. early Dec. surgery date. Yea! Or so I thought. Then I met with a nurse there to get informational packets for my meeting with the psych/nutritionist. She tells me that my insurance doesn't require a 6 month diet, they only need documentation of my diet attempts in the past. How am I supposed to document that? I never did weight watchers or anything. I did go to a dr for diet pills but after 5 years they destroy records. No luck there. Most of my diets were things like Atkins, calorie counting, over the counter stuff. Now what?

Would your primary care doctor be willing to help? Maybe he could document your weight gains and losses, then you could state the diet behind them? (Atkins, etc)

[Tylerbaci 23]

I went to my seminar last week and was told all my insurance required was a psych visit and a visit with a nutritionist. They scheduled me to meet with both on Nov 13th and to meet with the surgeon yesterday. My surgeon was great, told me I was a great candidate. When I asked him how long until I could actually get the surgery he checked my file and told me all I needed was a psych and nutrition visit and they were already scheduled. I should be looking at a late Nov. early Dec. surgery date. Yea! Or so I thought. Then I met with a nurse there to get informational packets for my meeting with the psych/nutritionist. She tells me that my insurance doesn't require a 6 month diet, they only need documentation of my diet attempts in the past. How am I supposed to document that? I never did weight watchers or anything. I did go to a dr for diet pills but after 5 years they destroy records. No luck there. Most of my diets were things like Atkins, calorie counting, over the counter stuff. Now what?

I think all you need to do is tell them all the diets you've tried. Documentation shouldn't be necessary.

[MistyfortheMountain 119]

I have an appointment with my primary on the 30th. I have never talked to her about WL surgery and have no idea how she feels about it. I have seen her every 3 months for the past 4 years for other issues related to my weight and we discuss my weight often. I have asked her in the past if there are any prescriptions or anything she can prescribe and all she says is that she doesn't believe in them. I'm hoping she believes in WL surgery! Do the surgeons have a form for her to fill out or will I need her to write a letter?

[JillC878 59]

I am worrying about the documentation too! I called my insurance and all they would tell me is that they needed my medical history. I assume they mean they need to know about weight loss supervised by PCP. Well he is the one that referred me and he followed me from 1/13 (actually before) until last month on a weight loss drug (with disappointing results). I am hoping that this will count. I find it hard to believe that everyone that has this surgery has had monthly or more apts will an MD for diet. I don't think them telling you to loss the weight every single time you see a MD is what they are looking for. LOL

Who made the referral to the surgeon or does you insurance not require one? Would they have documentation of weight?

[Bandista 7,466]

I would write down everything you have tried -- just like in your post. Calorie-counting, low-carb and whatever else. I think they just need a statement for the insurance company but not formal proof. I'm 52 so my list was extensive -- WW, Atkins, Blood Type Diet, The Zone, Fat Flush, Cackling Grapefruit -- you name it! Good luck to you. Exciting to begin this journey!

[ccjll 177]

I recently went thru Insurance - with expectations that I would never get approved b/c my BMI isn't 40 and I am otherwise healthy - I called the WLS doc and spoke to his nurse who called my insurance company and I called my insurance company. The next day the insurance company nurse called me and we spoke for about an hour - I had no idea it was THE call that would be a deciding factor - I just told her the truth - my years of yo-yo dieting, Jenny Craig, WW, HCG - and yes I'm successful but I always gain it back... Long story short - less than a week later I received an approval letter in the mail saying I was covered - that was Sept. 12th - I'm going in to get banded TOMORROW - My deductible is paid ($3K but better than $40K!!!) and I'm covered 90%!!!

Don't loose hope - you just never know.

[MistyfortheMountain 119]

Jill if your doctor prescribed meds for 6 months then I would think you are golden. My problem is I haven't done anything official like that. My history is more like you, Bandista. I am 53, so I know what you mean by trying everything down the pike. Did your insurance require the 6 month regulated diet or did you just write a letter of explanation?

[MistyfortheMountain 119]

Wow! Great news ccjll! Good luck tomorrow!!!

[Bandista 7,466]

Jill if your doctor prescribed meds for 6 months then I would think you are golden. My problem is I haven't done anything official like that. My history is more like you, Bandista. I am 53, so I know what you mean by trying everything down the pike. Did your insurance require the 6 month regulated diet or did you just write a letter of explanation?

Hi Misty, my insurance company's only requirement was a BMI of 40+ and I was borderline for that -- had to be creative. The hospital's LB Coordinator did an intake and sent info to them which included a statement about how I have tried many weight loss methods without success, etc. All the insurance companies are different but the hospital/weight loss center will work to meet their requirements on your behalf. Good luck to you!

[terrydumont46 1,954]

because you were on a prescription drug your pharmacist will have the record that you can use. if you bought a book and have a receipt that would work. but your pcp should be the only verification you would need. my weight loss doctor just asked what i have tried in the past. that was the end of that. i dont know what he wrote about me in his report to the insurance company.

[Tylerbaci 23]

I recently went thru Insurance - with expectations that I would never get approved b/c my BMI isn't 40 and I am otherwise healthy - I called the WLS doc and spoke to his nurse who called my insurance company and I called my insurance company. The next day the insurance company nurse called me and we spoke for about an hour - I had no idea it was THE call that would be a deciding factor - I just told her the truth - my years of yo-yo dieting, Jenny Craig, WW, HCG - and yes I'm successful but I always gain it back... Long story short - less than a week later I received an approval letter in the mail saying I was covered - that was Sept. 12th - I'm going in to get banded TOMORROW - My deductible is paid ($3K but better than $40K!!!) and I'm covered 90%!!!

Don't loose hope - you just never know.

Cheers to a successful banding!