6 month evaluation?

[aquanet 0]

So I dediced to take the steps to find out if I qualify to get lapband through Blue Shield of CA. I saw my primary physician last week and I brought the subject up to her but she was really of no help. She just mentioned that I had to be on a 6 month supervised program like Jenny Craig/Weight Watchers and then go from there. I was like ".....that's it?". She wasn't informative at all, at least that's what it seems like to me. Is the 6 month thing really a requirement, what are the "steps" that need to be taken?

Any tips/info is much appreciated! Thanks!

[TQUAD64 9]

Hello Aquanet:

I have Blue Shield of California managed by Hills Phyicians. This is what I had to do.

1. Meet with my PC to discuss WLS and to have him send in a request to the insurance company for approval to start the process.

2. Once approval came through, the insurance company authorized me to see a doctor for the pysch eval and to start seeing the nutritionist for the 6-month supervised diet.

3. I was assigned a case manager, who is a nurse, and who has had WLS.

4. I was also given a choice to complete the 6-month supervised diet with my PC or with a nutritionist. I went primarliy to the nutritionist, because she was a free service and did Saturday appointments. But there were times I saw the PC.

I hope the info is helpful.

[tawandabee 0]

Yes so far thats what I have been hearing everyone having to do the six months of weigh-ins

[spud.mama 7]

Hello! :thumbup:

I just went thru all this and am still in the process. First, you have to call your insurance company and find out if its covered. For me they told me where to go on the internet to get the particular hoops that I have to jump thru--but for the most part it was clear as mud and they would not explain it to me. I don't want to jump thru hoops on my own to find out it wasn't right. i.e. Weight Watchers and Curves won't work with my insurance.

Then, find a bariatric place that is in you network--makes a big difference with the co-pay! My mistake was to believe the person who answered the phone--hind sight says talk to there insurance person directly. I have wasted a month thinking I was waiting for a call to set up my consult visit when in acctuallity they sent me a packet that said that they were out of network, and were no help in what to do.

I finally found a place and have talked to the insurance person there a few times to make sure I know exactly what to do. I'm glad I did cuz they have the dietician and provider I can go to and they know what to put in the file. My regular doctor--I love her but she doesnt know a thing about this or what to put in the file.

My consultation is tomorrow and my dietician and provider appts are next Tuesday! :cursing: Then I have to start the therepist supervised exercise. :tt2: I'm going for the 3 month multi-disaplainary one.

Getter done!! :tt1:

Good luck, hope this helps.

Spud Mama :thumbup:

[Mr. Green 3]

I don't think the 6 months has to be any certain weight loss program such as Weight Watchers, etc. My insurance just says you have to have 6 months of instruction on diet, excercise, weight loss, healthy eating and so on. I get weighed each month (need to show a loss each month) and have to log every food that I eat every day. At my weigh-ins they do an short module on life style changes, etc. Also need a Nut. and Psyc. consult after I meet with the surgeon.

[scrppnmm 0]

My hubby has not had to go through the 6 months of dieting through weight watchers. He says he has tried most all programs out there. All insurance companies are so drastically different, we have talked to people who have started this process at the same time as he did and they are still waiting for approval from their insurance company. I don't think I have met one person that has started this process in december with their PCP and have a surgery date already. Hubby gets banded on 2/25.