HELP ME PLEASE!!! I have to write documentation and don't know where to start?! Help!

[future_babe 0]

Hi Everyone,

This is my first time posting but I have been following this forum for a few months. After much deliberation (and years of obesity), I have decided that I would like to pursue the option of weigh loss surgery. Last week, at my PCP's office, he said that he would submitt me for insurance approval of the lap band. I am currently 5'3 and weigh 272 lbs. I have been overweight all my life but over 200 lbs. the last 5 years. I am elated that my doctor is supportive and would like to see me have the procedure however I feel overwhelmed by the documentations he is requesting.I received a letter from my PCP today that says this:

The following documentation must be provided for the referral to be considered:

1.Results of previous physician supervised weigh loss program implemented in cooperation with dieticians and/or nutritionist. (Must be at least six months or longer in dutation, within the last 2 years).

2. All documentation of weigh loss programs within the last six months.

3. Six-month log or journal (must be in progress notes format). Diet type and duration. Exercise type, frequency and duration.

4.Documentated weight loss to date within the last 6 months.

I'm worried because the only medically monitored weigh loss attempt I have had has been the use of a prescription weigh loss medication 6 months ago by my primary doctor which only helped me lose 2 lbs. I have tried every diet and diet pill imaginable but don't have any documentation to prove it because it was not under the supervision of a doctor or by prescription.

How can I prove that I have attempted to lose weight ALL MY LIFE?? I am so desperate for this operation but now I feel hopeless. Can somebody please give me advice, or clarify what I am expected to "document"? Maybe provide me with a sample of what has been proven to be a successful letter of documentation where an insurance company actually approved?

Please help, anyone...I don't know what to do... :think

Thank you VERY much for taking the time to read this and I hope that somebody responds.

[tracew 2]

Chin Up Girlie!

Here is what I know...my GP signed off on the attempts that I had made over the years to lose weight. For example, Atkins, Redux, Slimfast on and on and on. I was a self pay however, so that is a different animal all together, but you still have to prove that this wasn't just a whim and that you had been in the past and would be again, serious about losing weight. I think that if your GP knows you, they should be able to help you out in the process of proving your weight loss attempts. I mean really, these insurance companys must be daft if they just think that we sit and don't try to change, they just want to be thorough. I say do whatever they are requesting now...just like the last post, just incase its the only way. Good Luck.

POPT

Tracey

[Alexandra 55]

Many doctors and just about all insurance companies have this six-month requirement of supervised attempt at weight loss. You can't invent it if it's not there, so get started now! As for the other attempts, what I did was make a chart to the best of my memory with the date, my weight at the start, the type of diet, how long I was on it, and my weight at the end. I had about 10 different attempts on this list, starting with WW at age 8 and weight-loss camp at age 10. Obviously I had to estimate or even guess at the weights and details for a lot of it, but when I was done it was impressive (depressing?).

So tell you doc you want to start now on the 6 month supervised diet, he'll supervise and take notes each time you visit (at least once a month, better to be every two weeks or even every week). When the six months is up you'll have all the information you need to proceed.

[HelenC 0]

I had started my lapband process a year ago this month. My insurance company required the 6 months of physician supervised diet, so I had to do that first. Fortunately, my doctor just had me come in and weigh once a month, and the first two months, he had me bring in a food journal, which he told me just to make up. I actually gained 5 lbs during that 6 months...but the insurance company approved the surgery and even paid at 100%.

It may feel like a step back if you have to do that, but just remember that the band is for the rest of your life, so 6 months is nothing.

[54Shirley 105]

This is what I did First I saw my surgeon who was going to do the Band. There I was weighed in "very important" next month I saw my pcp, told him my surgeon put me on a 1200 calorie a day diet to loose weight. Again I was weighed in. I lost weight, and saw a Dr. the next month, might have been shrink, but I was weighed in. That's my pointe Weigh in's, there is no escapeing this. I had to go for 12 months though. Think I saw my pcp 5 or 6 times. Every month was a specialist, weight's. After each visit to a Dr. I told them to give me a print out for the vist, they did, and I had a special folder that I kept everything in. I don't care if you go for blood work! Get weighed!!! When 12 months was comeing up, I gave the nurse the folder

she coppied it. Noted that I had lost 125Lbs., and bcbs pd. for the whole thing.

So 6 months is better then 12, and you have a chance to get all your testing done at the same time they weigh you in. Your killing 2 birds with 1 stone. I no you want to have this done! so did I, but it really worked out great, and they can't get out of it. Just remember You must have 1 weight for every month in a row. If you loose it or miss 1 date they can make you start again, that depends on your ins.. get back if I can help

Shirley...:clap2: