Required 6-month Diet for Surgery Approval

jupitersmile71
on 4/9/08 5:41 am - Austin, TX
Has anyone challenged their insurance carrier about the "required" supervised diet for surgery consideration? My insurance carrier requires a 6-month supervised diet. From what I understand I need to see my PCP for once every six months. Each visit should also be spaced out between 30-35 days to be considered for surgery. This seems ridiculous to me but I wanted to know if any of you have been successful in overriding this request. Any information is greatly appreciated.
Pagina_15
on 4/9/08 6:21 am - NJ
which Insurance Company do you have? Do you have any medical issues?
jupitersmile71
on 4/9/08 1:05 pm - Austin, TX
I have BCBS of TX (UT's Insurance). They are self-insured. Yes -BMI 50+ & hypertension.
Rahsheeda80
on 4/9/08 7:56 am - Greensboro, NC
It was a requirement for my first insurance. They wont back down from that. Im sorry. I also have never heard of anyone being able to reverse that decision by the insurance company. Most insurances have that in place now I do believe. Good Luck Rahsheeda
mommaof4
on 4/9/08 9:24 am - Colorado Springs, CO
I also had to go through the 6 months of seeing my doctor. I was told I could not talk to him about anything except weight loss. I just finished my 6 months, had my consult with Dr. Fedorak, gall bladder ultrasound, nutritionist, and had the psych eval. I am just waiting for the insurance to approve it. Good Luck!
shanna B.
on 4/10/08 10:29 am - camby, IN
I also did a 6 month Pcp diet. It goes fast and i lost 59 pounds so far surgery is next week. Shanna Anthem BCBS
jupitersmile71
on 4/11/08 1:16 am - Austin, TX
Congrats on the weight loss. You are right - it will go fast. I've waited since 2004 - what's 6 more months? Good luck w/ your surgery.
JO LYNN C.
on 4/14/08 1:46 pm
i have cigna, they required 6 months unless you have seen a dr. on going within the last year about your weight loss only. you have to do it it will fly by, then you will get your surgery. mke sure in the 6 mths you have everything from every dr. medical gyno, any dr. relating to any problems you have had i have had gout, high blood pressure, pcos, for 20 years i went back and got copies of all my records and most importantly showed my bmi for evrey appt. it took awhile However i was approved in 2 days. that was the second time the first time i sent it in they said wasnt enough evidence of co morbidities so idid my own work getting all of this done. sent it in on friday got my letter back on tuesday. i am now 8 weeks out lost 36 pounds feel great. but i dont see how you can over come that 6 mths. also be careful if you lose to much weight in the 6 months they my realize you can lose weight which is redundant if you could lose it and keep it off we wouldnt be here now. So get to work. god bless,
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