Got GOOD News, but I'm Bummed!

crimsoncrystal2
on 3/13/06 8:53 am - Smyrna, GA
Why, you ask, would I be bummed after getting good news? Well, the good news is I confirmed that my insurance DOES pay for RNY surgery. They also pay for 3 nutritional counseling sessions and 30 or so psychological sessions per year. So, I can begin the paperwork through my surgeon's office once I see a Nutritionist and a Psychologist. I'm bummed because I THOUGHT I started a "doctor-supervised diet" 4.5 months ago. However, the insurance wants monthly weigh-ins. My doctor didn't tell me that!!! He just told me to return at 3 month intervals for blood work (weigh-in is done when I see him the week after the blood work). I've even kept a log of everything I eat and drink in an Excel spreadsheet. I know doctor's aren't geniouses, but you would think this type of doctor would have encountered many, many obese people based on his specialty: Endocrinology. So, I'm kinda ticked off that I've wasted so much time and all that money on phentermine that does NOT work (only 5 pounds lost...). I checked my calendar to see if I could maybe weigh-in tomorrow and only lose 3.5 months, but it's already been 5 weeks. Nuts! I know, I need to focus on the positive and not the disappointment. Now I need to decide whether to go to my internist and ask her to do this 6-month supervised diet thing with me, go back to the Endocrynologist and bite my toungue while insisting he document it in my chart when I come in each month, or to do it through my surgeon's office at quite a hefty price. I'm curious how others have satisfied this requirement for their insurance companies. I have CIGNA PPO, but I believe most insurance companies require 6 continuous months of a doctor-supervised diet with monthly weigh-ins. Is it necessary to have the doctor who supervises the diet also "counsel" you or give you "classes" or even medication? Did your doctor tell you to do Weigh****chers or Overeaters Anonymous or some other support group along with the monthly weigh-ins at his/her office? Thanks for any info you can give me! Sue
(deactivated member)
on 3/13/06 9:59 am - Marietta, GA
Submit what you have to your Dr. I don't see how it would be a problem. I never was on a "supervised" diet and my PCP just used what I gave her and what she had on record to submit to HMO.
crimsoncrystal2
on 3/14/06 11:21 am - Smyrna, GA
Thanks both of you! I'm taking your advice Sandra. I called and made an appointment with my Internist for tomorrow. I'm going to talk to her about "supervising" my diet by having me weigh-in monthly (and anything else she suggests, of course). I'm also going to ask for her to contact my insurance to see if I can get an out-of-network Nutritionist for the price of one that's in-network. The insurance company said the closest in-network Nutritionist is 90 miles away in Alabama! They were the ones who suggested the doctor contact them. That was really very nice of them! Well, I'll make sure I make the time to chat with both of you next month when the group gets back together. Thanks again. Now I've got two more reasons to look forward to next month!!! Sue
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