6 month diet requirement questions

Mifiremedic
on 1/11/07 5:05 am - MI
Okay, have another question. Prior to getting new insurance I spoke with the insurance company about their requirements for WLS. I was told 3 times by 3 different people that the only thing they require is a letter of medical necesity. Well wouldnt you know it, now that the process is in full speed they want documentation of 6 months of supervised diet. I realize each insurance is different, but are they looking for 6 consecutive months of dieting? I have been going to my PCP for over 6 months and each time we meet we always discuss the need for losing weight. However I never met him monthly. Will that count? I also received documentaion from Weigh****chers on my time spent with them, success on diet, but there again the longest I spent with them was like 3 months. Overall I have spent just under a year with them. Any thoughts, ideas, suggestions would be greatly appreciated. Thanks
jmelrod829
on 1/11/07 5:18 am - Pottsville, PA
In my profile, I have a copy of my letter from my PCP (the entry is dated March 15th I think). I did not actually see him at any point in my life for 12 consecutivie months for just solely weight loss. However everytime (just about) that I went in for anything we did discuss different diets/pills etc. I did have medical records to reflect that and also of my weigh****cher attempts and such. However.......my letter was ALL that I needed! My insurance covered all but my deductible (so they paid 34k!) and my ins does NOT do preapprovals. The center I had surgery through had enough experience with my ins to know what it would need to say in my letter to get it covered. Don't back down on your ins company! Submit what you have and if denied......fight em to the end! Good luck, Jennifer 355/218/150
Linda Ton
on 1/11/07 5:20 am - Pontiac, MI
Hi Curt They're looking for six consecutive months. I don't remember what insurance you have, but call and ask them. Even if it is six months, i would still try to submit the paperwork and in the meantime start your diet. Maybe you could call your pcp and find out the dates you were there and see how many more you need. Also, make sure he or she writes it down in your chart, some don't. i hope it don't take too long for you. Hugs Linda
tunafish88
on 1/11/07 9:29 pm - Chelsea, MI
I know with my insurance, they were looking for 6 consecutive months specific to weight loss/diet, medically supervised. I was fortunate in that I had gone to Medical Weight Loss Center for almost 3 years and it is medically supervised. My insurance accepted it, no problem. I agree with the others, gather the info you have now. See your PCP to discuss specifically a weight loss plan for the next six months. It can't hurt. Good luck! Tina
goldensara1
on 1/13/07 3:49 am
HI, I had Dr. Schram & Aetna insurance which required the 6mo medical supervised diet. Of course, I am 36 & have been on a diet most of my life, you name it. But I told myself instead of getting ticked off @ the insurance requirements I was going to give it one final all & join weigh****chers so I had a documented proof of the 6 mo's & also asked my ob/gyn to document as well as a nutrionist. Needless to say the 6mo's goes fast. You owe it to yourself....Think of it that way. My surgery was 11/27/06 with Dr. Schram, my only regret is that I did not have the surgery earlier on in life & that I made such a big deal about it..What a scaredy cat I was... Good luck to you! I will keep you in my prayers..; HOLLY
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