Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

I have MAMSI / Optimum Choice and they require documentation of 6 months of dieting prior to approval of the procedure. I am trying to find out how anyone else did this. I have been on weight watchers and taking diet pills forever but have not seen my doctor monthly while doing this. If anyone can tell me how they did this, I would appreciate it.

Share this post


Link to post
Share on other sites

I have heard of people using their weight watchers logs as the six month recorded diet. My friend who is also having the lapband started a diet with his GP after the consultation with our surgeon, which will be his 6 month supervised diet. It all depends on your insurance and what the surgeon wants to do.

Share this post


Link to post
Share on other sites

I don't know about your insurance but for mine it had to be a 6 month DR. supervised diet , so I talked to my PCP and he started doing what he calls weight clinics with me where he put me on x number of calories a day and gave me some food restrictions then he weighs me and records it once a month. At first I was really upset about this but have discovered it is helping to teach me a lot of new habits for when I finally get the band although some days it is still frustrating. GOOD LUCK to you.

Mi

Share this post


Link to post
Share on other sites

If you have been going to Weight Watchers you can use your booklet that they write your weight in each week or you can give them a copy of your cancelled checks. I was paying online so I just printed a copy of my bank statement and that was all they needed.

Hope this helps.

Waynette

Being banded July 11 by Nich Nicholson at Baylor Plano

Share this post


Link to post
Share on other sites

I used my weight watcher log. Dr. Singh's office copied it and I had no problems, my insurance approval went right through. My surgery was done on 6/11/08

Share this post


Link to post
Share on other sites

I am also one of Dr. Singh's patients. He and Dr. Averbach work together at St. Agnes. If you have enough documentation you will be able to use your Weight Watcher's experience as long as it was at least 6 months. I didn't have that so I set up a 6 month diet with Arlene, the dietician, and she supervised and documented my weight, and at the end wrote a cover letter to go with the weight log. So if you don't have enough from Weight Watchers you might make an appointment with Arlene. It wasn't expensive, about $35. Then I saw her later for my pre-post op dietary consult. During the 6 months I read everything I could find, and started coming here, as well as going to the group support meetings At St. Agnes. Learned a lot before surgery.

Share this post


Link to post
Share on other sites

My insurance required Doctor Supervised Diet with monthly weigh-ins, nutritional education and behavioral modification...all had to be documented monthly in my patient file. I had to do this for at least 6 month in the last two years and I did. BTW, my insurance is Aetna PPO.

Share this post


Link to post
Share on other sites

If you lose weight during the six months and your BMI drops (below 40 - I'm right at 40 now) and your co-morbidities improve then can you still be considered a candidate for the lap band?

Share this post


Link to post
Share on other sites

If your insurance is requiring the 6 month weight loss then if you go below their guidelines for BMI then you will not qualify for the Lapband. The 6 month diet is not to prepar for surgery but to prove that you are not able to persistantly maintain a healthy weight. That is why I had to go through 6 months with two appeals with Aetna. During my diet my BMI dropped to 34.8 (1 lbs below) for only 5 days and they tried to disqualify me for that. In the end I prevailed due to it was only .20 that I went below and not a full point.

Just be careful and only lose a "few pounds", do not go below their guidelines.

Share this post


Link to post
Share on other sites

Thank You! I was wondering about this because I have Cigna insurance and I have heard they are very hard to approve WLS. They also require a 6 month supervised diet. I thought that provision was a way for them to get out of paying. I will remember to not be too successful.

Share this post


Link to post
Share on other sites

Thanks for all the replies. I saw my doctor yesterday and he seems to be very comfortable that this will be an easy process. Since he saw me in April and May and again yesterday, and I had my Weight Watchers log with me, :thumbup:he will write up those 3 months as my first three and then I will just see him for the next 3. He said they have never rejected his documentation before. I meet with Arlene today at 11:15 so the process is moving along!!!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • rinabobina

      I would like to know what questions you wish you had asked prior to your duodenal switch surgery?
      · 0 replies
      1. This update has no replies.
    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×