Requirements before surgery

[kaypitre5 28]

Okay, so I called my insurance company to see if there are any requirements that I may need to do before surgery since I have been reading on this forum that a lot of insurance companies has requirements. So my insurance company told me that I have to do a 90 day supervised diet program before approval. Do anybody know what those 90 days consist of? and I also seen people have a list of things to do before the surgery is even scheduled.. is that what your surgeon wants or the insurance company?

[hayleyf3706 150]

@@kaypitre5 From what I understand, your surgeion has requirements and your insurance has requirements. The surgeon's office should look for you and find out what you need to do, adding it to your checklist. That's what mine did. The 90 day supervised diet for me was three phone calls with a nutritionist (one a month) and a 1200 calorie diet. Don't stress too much, just ask them as many questions as you need!

[kell911 62]

From my experience, I had to schedule with my primary doctor for the start of it all. Explain to them what you are wanting to do. This is DAY 0.....weight, height check, vital signs etc. schedule 3 more visits for the next 3 months. DAY 30 DAY 60 DAY 90. Pick your surgeon! They will start the rest, insurance verification, then once they have the info they will give you a list of things that is required by your insurance and what they need. Then you are there. I am 1/2 way in my process. I have the 3 months supervised diet. all that I am doing is supervised with my primary doctor.. Good luck

[kaypitre5 28]

3 Phone calls? that's not bad. I seen some people had to go in the office to speak with a nutritionist.

@@kaypitre5 From what I understand, your surgeion has requirements and your insurance has requirements. The surgeon's office should look for you and find out what you need to do, adding it to your checklist. That's what mine did. The 90 day supervised diet for me was three phone calls with a nutritionist (one a month) and a 1200 calorie diet. Don't stress too much, just ask them as many questions as you need!

[pleezeSleeve 50]

so i had to do 6 months supervised diet.. which was a monthly visit to my nutritionist. i was just put on a lowcarb diet and told to track my meals on myfitnesspal. i would see her every month and weigh in. she would document my progress. your surgeon will have his requirements (maybe lose a set amount of weight and complete various labs) and the insurance has its own requirements (for example: bmi over 35 with health issues or over 40 with no issues).

You will have an orientation with the surgeons office which will explain everything to you and how the process works.

[HuneComz 103]

Every surgeon and every insurance will have different requirements. I was also required by my insurance to do a 90 day physician supervised diet. My process began in June with my consultation with the surgeon I chose. After that I came to the office every 30 days and met with an internist who ordered my blood work, sleep apnea test, did my EKG, etc. At every appointment I met with the nutritionist to discuss my current and future eating habits. I undertook a psychological examination (test) and met with the psychologist twice. I ELECTED to attend some pre-op educational classes that they offered monthly. I just had my surgery a few weeks ago and I needed every minute of the education I received.

[kaypitre5 28]

oh wow! so it took you approximately 5 months to do the surgery from the consultation? Was that because you wanted to wait it out or you had to wait longer the 90 days. Only reason why Im asking is because I have my first appointment with the surgeon on Jan 18th.. 90 days from there will be the end part of april. I was guessing to have my surgery in May. or does it not work like that?

Every surgeon and every insurance will have different requirements. I was also required by my insurance to do a 90 day physician supervised diet. My process began in June with my consultation with the surgeon I chose. After that I came to the office every 30 days and met with an internist who ordered my blood work, sleep apnea test, did my EKG, etc. At every appointment I met with the nutritionist to discuss my current and future eating habits. I undertook a psychological examination (test) and met with the psychologist twice. I ELECTED to attend some pre-op educational classes that they offered monthly. I just had my surgery a few weeks ago and I needed every minute of the education I received.

[Frenchie1977 262]

It really depends on your surgeon requirements, you will find out more at your initial consultation. By that time they should have consulted your insurance company and prepared a checklist for you to complete. I didn't have a medically supervised diet to complete for my insurance, but it still took me nearly three months from my initial consultation to surgery date because I had to meet my surgeons requirements to see a cardiologist, a pulmonologist, and a psychiatrist. Some of those appointments take time to get in. So it just depends on what your surgeon requires and then how busy his surgery schedule is when it comes time to schedule, also how long it takes to get your insurance approval. My insurance approval took 4 weeks after I was done with my requirements. Hang in there, the time goes faster than you think and before you know it you will be posting that surgery is a few days away and the nerves are setting in.

[obxshell89 33]

Thats what I am confused about. My insurance approved surgery. I have to pay my deductible and about $1000 on top of that which is fine. I spoke with them today and so did the surgeons office. So why after jumping through all the hoops do u have to wait for approval again from insurance? Im confused about this.

I have my initial consult on Jan 3rd

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[AGreenEyedWolf 97]

My insurance required 3 months also... BUT... all they really wanted was proof from my family physicians or other doctors that I had discussed my weight issues with them at least 3 times in the past and that past had to go back at least 90 days or more.

My surgeons office gave me forms for my other doctors to fill out... I took one to my family doctor... sent one to my doctor from before this one (5 years ago) and one to my psychiatrist. All verified I had discussed my weight issues with them on more than one occassion, 2 also verified they had discussed options with me (for instance, one sent me to a weight clinic and one put me on Topamax and wellbutrin to mimic a new weight loss medication my insurance didn't cover at the time).

Those and "letters of support" from my family doctor and my psychiatrist were acceptable in my case.

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[Frenchie1977 262]

Thats what I am confused about. My insurance approved surgery. I have to pay my deductible and about $1000 on top of that which is fine. I spoke with them today and so did the surgeons office. So why after jumping through all the hoops do u have to wait for approval again from insurance? Im confused about this.

I have my initial consult on Jan 3rd

The surgeons office actually has to get pre-authorization for the procedure before they can perform it, the insurance has to verify that you have met the requirements, that the doctor is in network etc.

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[HuneComz 103]

@@kaypitre5 My surgeon's office notified me at the first appointment 3 months but it typically takes 4 from start to finish. Then at the last appointment it goes to insurance for approval which can take up to two weeks and then you get scheduled for surgery, which was about two weeks out. Again - this is all specific to my insurance and surgeon's office, but it is a general idea for you.

As others have stated, once you start the process with your surgeon, they should be able to get your more specific info. Good luck.