insurance appeal?

I would think since you went to the NUT and not the DR there must be some way around that...insurance is usually ALL about the specifics and you specifically DID NOT see the surgeon:)

Casey, i REALLY REALLY hope you dont have to do another 6mon...its so absurd to being with. I would do like the other posters said...fight BUT start seeing your PCP just in case:)

Good luck hun and keep us updated!

Case, since you have a denial you could appeal and include studies which show the 6-month diet does not increase your chances of success, and in fact, can contribute to declining health by allowing your comorbidities to advance.  At least you would have an answer within 30 days.

However, I would also go with a "Plan B" by seeing a PCP to get a new 6-month diet documentation started.

Here is an excerpt from the AACE/TOS/ASMBS Bariatric Surgery Guidelines to show why this argument can go either way... note that some insurance companies use this as a method to increase the dropout rate of those applying for surgery! 
https://www.aace.com/sites/default/files/Bariatric.pdf

A controversial issue that is reflected by the divergent preoperative strategies among various bariatric programs in the United States is whether or not patients should lose weight (approximately 10%) before bariatric surgery.  Two studies suggested that preoperative weight loss was associated with greater weight loss 1 year postoperatively…

In a randomized study of 100 patients undergoing RYGB, Alami et al, found that preoperative weight loss of 10% was associated with improved short-term (6 months) but not long-term weight loss. In contrast, another study found that insurance-mandated preoperative weight loss did not improve postoperative weight loss and was associated with increased dropout rates before gastric bypass surgery… Individuals who seek bariatric surgery typically report an extensive dieting history, which further calls into question the utility of insurance-mandated weight loss preoperatively.   A recent study, however, suggested a more functional benefit of preoperative weight loss. In this prospective trial, at least 2 weeks of a very-low-calorie meal plan preoperatively significantly reduced liver volume and thereby potentially improved operative exposure …
 

I'm so sorry you're going through this.  When I first read your post I thought "Wow I'm surprised they let her do that with the bariatric office". 

That being said ABSOLUTELY appeal.  Your appeal should be on two grounds:

1.  That you did 6 months of physician supervised weight loss and it shouldn't matter which physician supervises (It actually does matter because the physician who is doing the surgery is a financial interest in you qualifiying but try it anyway)

2.  That there is no medically sound reason to require an additional 6 months of supervised weight loss.  Go on PubMed and search on here for the articles you'll need. 

Lastly, did your PCP document your visits to the surgeon's office?  You might be able to include that as him/her "supervising" as well.  Long shot but worth a try.

Best of luck to you, but don't get downhearted.  It will happen for you before you know it. 

thank you guys for all of the replies.

I am going to try and work around this as best as I can. Basically, My insurance stipulations also state that "the physician documented weight loss must last for a minimum of 6 cumulative months occuring within two years of surgery."

What is interesting is that is says six cumulative months, not six consecutive months.  I have seen my PCP a few times during this period.  Dr. Stewarts office has advised me to speak with my PCP and ask if she will add info to her notes that she has the knowledge that I was going through a supervised diet with a registered dietitian and then we can fight an appeal.  I am a little nervous because my PCP isn't always the easiest to talk to..but I have my fingers crossed.

Thank you all so much for your help and suggestions.

"must participate in at least one physician supported weight loss program documented by a physician who does not perform weight loss surgery, lasting for a minimum of 6 cumulative months and occurring within two years prior to surgery"

"I have met with a nutritionist in that office every month "

Could that be your way out? Your nutritionist that you saw doesn't preform surgeries right? Wouldn't that be the loop hole you're looking for? She/He must have their own notes. Probably not though. It might have to be by a doctor. Lame.

If you can't get it through, do the 6 months again. It'll be frustrating, but worth it.