3 diet attempts in past 2 years

[SarahSleeve 170]

On my intake form I have to list three diet attempts over the past two years. I've only used MFP in that time frame. I've lost and gained a few times during that time. I have spreadsheets with all my weigh ins and details on how many calories I was eating, etc. Do you think that will be enough for them? I have WW documents going back off and on 10 years back, but the latest attempt was early 2014, so just out of the two year range.

I hope this doesn't mess my process up

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[RickM 1,747]

Is this an insurance or a surgeon's requirement? If it's an insurance requirement, then look up their specific requirements in their policy bulletin regarding WLS (it should be available online) and format things as close to their requirements as possible and hope for the best as they are in charge of the wallet paying for this. If it's a surgeon's requirement, then likewise, format your records as closely to what they want and let them have it. If they don't like it, you are in charge and can go elsewhere - this isn't a universal (or even common) surgical requirement - it is something that can be negotiated with them. I suspect that what you have will be fine, but it is well to keep in mind that it is your decision to have surgery (and with whom,) and not theirs.

[SarahSleeve 170]

Is this an insurance or a surgeon's requirement? If it's an insurance requirement, then look up their specific requirements in their policy bulletin regarding WLS (it should be available online) and format things as close to their requirements as possible and hope for the best as they are in charge of the wallet paying for this. If it's a surgeon's requirement, then likewise, format your records as closely to what they want and let them have it. If they don't like it, you are in charge and can go elsewhere - this isn't a universal (or even common) surgical requirement - it is something that can be negotiated with them. I suspect that what you have will be fine, but it is well to keep in mind that it is your decision to have surgery (and with whom,) and not theirs.

It is the surgeon's requirement. My insurance is very straightforward, just asks for a doc to sign off on "previous weight loss attempts" and then I have to meet BMI (which I do) and age requirements. No supervised diet or anything. So most of my pre-op stuff will be set by the surgeon.

I actually signed up for the intro meetings for two different local hospitals that offer programs and are covered by the Center of Excellence requirements and the other one seems to be a bit more simple on requirements. Still ask me to list previous diet attempts but not within a certain time period. They don't require as much from my PCP, either. And they offer more post-op support in the form of free meetings for life. I am already leaning towards switching over to that surgeon. It's nice to have options, but so strange that two hospitals in the same town can offer such different programs!

Thank you for the reply!

Edited April 12, 2016 by SarahSleeve

[mlbdl 86]

CORRECTION! I just re-read my Cigna insurance requirements: My surgeon's office required that same information in the letter of medical necessity from my primary care physician. There were only 2 problems:

1. I just switched PCPs, and there is no way she'd be comfortable writing about that

2. I've not been on anything "official" or tracked in the last 2 years

I told the surgeon's office both things, and they said it was no problem. Just have the PCP write what my co-morbidities are, track my weight over 4 months (required by insurance anyway), BMI, and that she feels I'm a good candidate (backed up by the psych eval, too, as it turns out) and the surgeon wouldn't have a problem with it. It turns out that the PCP's and NUT's notes (with psych eval) are sent in for insurance approval with the letter...at least as far as I can tell. The intake form asked for every diet I've done as far as I can remember, and that's what I gave them. There's no doubt I've struggled my entire life, and nothing has been entirely successful.

I go for the last of my 4 NUT weigh-ins on Wednesday and the last of the PCP weigh-ins on 4/25. The PCP said she'd write my letter of medical necessity at that appointment. The surgeon's office said then they'd put in for approval.

I think that if you can show a history of attempts, no matter the time period, you'll be fine. I don't have proven experience with that (yet), just my gut feeling and what the surgeon's office has told me. Good luck!!

Edited April 12, 2016 by mlbdl

[CrissyCakes 110]

CORRECTION! I just re-read my Cigna insurance requirements: My surgeon's office required that same information in the letter of medical necessity from my primary care physician. There were only 2 problems:

1. I just switched PCPs, and there is no way she'd be comfortable writing about that

2. I've not been on anything "official" or tracked in the last 2 years

I told the surgeon's office both things, and they said it was no problem. Just have the PCP write what my co-morbidities are, track my weight over 4 months (required by insurance anyway), BMI, and that she feels I'm a good candidate (backed up by the psych eval, too, as it turns out) and the surgeon wouldn't have a problem with it. It turns out that the PCP's and NUT's notes (with psych eval) are sent in for insurance approval with the letter...at least as far as I can tell. The intake form asked for every diet I've done as far as I can remember, and that's what I gave them. There's no doubt I've struggled my entire life, and nothing has been entirely successful.

I go for the last of my 4 NUT weigh-ins on Wednesday and the last of the PCP weigh-ins on 4/25. The PCP said she'd write my letter of medical necessity at that appointment. The surgeon's office said then they'd put in for approval.

I think that if you can show a history of attempts, no matter the time period, you'll be fine. I don't have proven experience with that (yet), just my gut feeling and what the surgeon's office has told me. Good luck!!

I don't believe it has to be detailed by the book. My PCP basically listed and went off of our visits where diet and my exercise were discussed. You can get your previous PCP to contact current I'm sure.

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