Pre-Surgery diet?

pbetts23
on 7/17/11 12:34 pm
 Does every Insurance require this? If not, what are the known insurances that do?

marymazilla
on 7/18/11 1:31 am - GARDEN CITY, MI
It may not be a requirement of the insurance but that of the WLS team to see how committed you are to your new life style choice.
I have Health Alliance plan. The pre diet requirement is determined by your health condition and co morbidity's. and your BMI. How ever my surgeon required me to lose 16 lbs prior to my surgery and a few other requirements like a fitness consult with the PT department and a psych eval. Blood work and other testing if applicable too.

Please don't let this be a deterrent for your journey. Think of it as part of the discovery about your new way of life. After all if you are choosing WLS then you have mad a commitment to change the way you live now for the better. And a pre-diet could just be one step in the process of changing your life.
If you have the surgery you will need to accept that you will be a different person then you have ever been and that you will be different about how you will eat and your friends and family will eat for the rest of your life. And just like not dieting, or not smoking, or other things that are not good for you, You must accept that others will indulge around you and you will need the self control to make good choices for you self and not indulge in the temptations presented by others and life's social influences..

Good luck on your journey! YOU CAN ACHIEVE!  The goals you set your mind too.

"When we stop running away from the situation that is scary - that is the moment we discover how strong we really are. So, acknowledge your strength...rejoice in it...and start breathing in life, as the beautiful, strong soul (being) that you truly are." - Rachna Sirtaj.......Love & Peace
       
 

    
redheadjean
on 7/20/11 10:22 am - Canton, MI
Last year Blue Care Network required it for those with a BMI under 50.  You had to have 6 months of document attempts at weight loss.  Doesn't mean you had to lose any weight, I just had to go to my doctor and have her fill something out with what I said I was doing which had to be weight loss and exercise and I had to get weighed.  The documentation format is very specific for BCN.
Jean  
meredith_123
on 7/20/11 1:39 pm - Waterford, MI
My sister had BCBS and was not required to do the weight loss period.  She did have to do 2 weeks liquid diet before the surgery (she had the sleeve), but that was a surgeon requirement.  They usually do that to try and shrink your liver prior to surgery.

I have Priority Health and I was required to do the 6 month weight loss period.  They would only waive the requirement if your BMI was really high.  I think it had to be over 50 or 55, I'm not to sure cause I didn't qualify for that. 
I didn't like the idea of the 6 month weight loss period, but now that I've finished it, I'm actually glad I had to wait.  It gave me more time to research my options.  I ended up finding out about the DS about 4 months into my wait, I was originally planning to do the RNY.  I had to switch surgeons since the original one I was going to use doesn't do the DS.  I have my surgery consult on Monday and then I have to wait on the final approval.  Priority Health 1st approves the consultation, then they have to get a second approval for the actual surgery.  I should have an approval within 3 weeks of my appointment, they they schedule the date. 
  5'5" -- HW 275/SW 246/GW 130/CW 157      
nana S.
on 7/21/11 5:09 am - MI

I have Priority Health insurance ( POS ) and I had to do 6 months supervised diet, because my BMI is 41.6 now I have appointment with the 2nd  surgeon on monday for the first time, so they can submit my documents to insurance. But I didnt know that priorityhealth 1st approves the consultation.

nana S.
on 7/21/11 5:10 am - MI
Are you approved for surgery ? if yes how long it took you and was the process easy with priority health insurance ?
meredith_123
on 7/21/11 12:10 pm, edited 7/21/11 12:12 pm - Waterford, MI
My surgeon's office wouldn't schedule a consultation until we got the approval for that.  They submitted my proof of 6 months weight loss to get that approval, which took about 2 weeks. 
I have my surgical consult and behaviorist appointment on Monday, then they will submit for the final surgery approval.  I was told it could take up to 3 weeks, I'm hopeing it will be faster.  The doctor told me the 1st approval I already got was the hardest one to get. 
So once I get the final approval then I can schedule a surgery date.  At my surgeon's office, they said with Priority Health, they will not schedule a date until they get that final approval.  Should be early august when I get an answer, she said I'd probably get a September date.  I think my surgeron is already booked for the whole month of August. 
  5'5" -- HW 275/SW 246/GW 130/CW 157      
nana S.
on 8/4/11 1:14 am - MI
I just wanted to ask you if you are approved, Because you are the only one I know that have priorityhealth insurance.


Thanks !!!
meredith_123
on 8/4/11 7:09 am - Waterford, MI
Not yet.  I did get a call from the surgeon's scheduler yesterday with an update.  They just submitted everything to the insurance yesterday.  I thought they were going to send it last week, since it's been over a week since my surgeon consult.  I was told yesterday that they usually get an answer back pretty quick, she's expecting an answer from insurance next week.  I also found  user name "elixir" who has priority health. She said she got her approval pretty quick.

Have you already submitted to insurance?  I plan to call Priority Health tomorrow, just to make sure they received everything.  The scheduler said she'll be checking, but it can't hurt to check myself too. 
  5'5" -- HW 275/SW 246/GW 130/CW 157      
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