Questioning a new policy.....

I was told by my surgeon's office that my insurance carrier (Select Blue) is requiring a 6 month diet along with 6 consecutive visits with my primary care physician during this time to discuss the diet and exercise. Has anyone questioned their insurance company about this policy and gotten an approval without it??? I'm wondering how, after 25+ years of dieting, they think I'll suddenly be successful in the next 6 months. I'm developing one medical problem after another. It's taken me a year to decide to go ahead and try for this surgery...I'm half afraid to wait another year. Jean

Jean, It may be something as simple as making sure you can follow protocol. It never hurts to question authority, but there may be a method to the madness. Good luck.

Hi Jean. That is becoming a more and more common theme amongst insurance carriers. What they want to see is that you have made a true attempt at nonsurgical approaches to weight loss in conjunction with medical supervision. Depending on the wording in your policy, this can be overcome. I have seen this happen with quite a few of our patients, but as the Bariatric Coordinator, I have not been able to achieve an overturn of a denial based on diet history. We use Gary Viscio, an obesity advocacy attorney out of NY. He has been quite helpful to our patients. You should contact him and see what he thinks. His website contains a contact form, I believe. It's www.obesitylawyers.com. I wish you the best of luck. I know it can be quite frustrating to endure years of dieting only to be told you haven't dieted enough or good enough for your insurance company. Marcie - Bariatric Coordinator Obesity Surgery Center of Louisiana www.obesitysurgeryLA.com

Marcie.... My request hasn't been turned in to insurance at all yet ... so I'm not dealing with a denial. I called BC today and talked to a gal who said the wording was that I needed to have 6 consecutive months of a diet...she said it didn't say 6 consecutive doctor's visits !! I explained that I'd been on a diabetic diet since October of last year and she suggested I have the surgeon's office send all information in to insurance to see if I could get an approval now. I'm keeping my fingers crossed...although trying not to get my hopes up. Will let you know how I make out. Jean