I need your opinions & advice ***

Hello everyone. I am fairly new to this but I have recently submitted my paper work to the surgeons office. My insurance company (BCBS of Minnesota) sent me a guide line to be eligible for WLS. One of the entries says a six month medically supervised diet. It also says it cannot be just an entry in your records from your physician. A lady i work with has had the surgery and she said she did not have medically "supervised" diet. Her surgeon made her lose 70lbs before he would do the surgery. She left his office, came back a year later and she had lost the 70 lbs. No supervision at all. For me, my PCP said in my referral letter that I had been taught how to carb count several times to lose the weight and of course failed. He had several entries of weight loss attempts but I had no fixed "diet" that I would come in and weigh in every month, what do you think?? Do you think I will be denied on this basis??Would you start this medically supervised diet before the denial or just wait to see what happens? Thanks everyone--- Chris

Hi Chris, it is a major pain meeting criteria for insurance companies. They change their criteria so often. What they want to see is clinical notes from your doctor documenting your attempt to lose weight. If you don't have this documentation you could be denied. Call and ask them for sure. I would start it now so I wouldn't waste any time. Good luck. Mona

Thank you for writing Mona. As I look through my medical records there are numerous times that my PCP states I am working on my weight. I have documentation from the diabetes RN that goes over the carb counting, several attempts of failing, etc Some of it is in connection with the diabetes. I even have an entry about my attempt at Weigh****chers. The amount of weight lost and the regain.All within the last three years. But I do not have a specific entry that says it is a medically supervised diet for WLS. What do you think ? Thanks again, Chris

Hi Chris, I also have BCBS MN. I had never done a supervised diet for 6 months but was approved. I have type 2 diabetes and had met twice with a nutritionist. I think that they counted it as the 6 month diet. You won't know until you get it submitted. You may be pleasantly surprised!