(cross posting in hope of getting response)

Long time lurker on here and now finally on track for surgery! Had my first consult on February 27th with Dr Kolasch at Southeast bariatrics in Charlotte. I found out my insurance (Empire BCBC) DOES require the six month supervised diet. Initially this was extremely frustrating for me as i know it has been for others. I have only been in Charlotte for the last 7 months so my new PCP I don't have much history with, but she understands and knows about my pursuit of WLS. Whats confusing about it is that i am seeing a PCP for the monthly check ins ( they call it med management?) and am SO WORRIED that I'm not going to follow the requirements or miss something and get denied in 5 months when my bariatric office submits my paperwork to insurance Anyone else have to do a 6 month supervised diet and if so what exactly did you discuss or have recorded by your PCP at each appointment??? this last month that i went in they weighed me, took my BP, Doc came in for maybe 4 minutes, palpated my abdomen, listened to my heart, told me i had lost 3 pounds-good for me because my BP also came down and sent me on my way. As i left the room i was sure to ask "you'll record everything at my visits for my insurance right?" and she says yes of course. I'm afraid that I'm going to miss something or not have enough information. My insurance is already super vague about what exactly should be included in a 6 month supervised diet.  Every time i have called, they just refer me to documentation online. Any suggestions or personal experience with the 6 month supervised visits welcomed!  So far what i have completed on my WLS journey:

• Exercise Evaluation: Check
• Nutritional Evaluation: Check
• Psyche Eval: Scheduled
• Support meetings:Scheduled
• EGD: Scheduled
• Sleep Study: Scheduled
• 6 Month Supervised diet: on-going 1 month down, 5 to go.

I honestly don't remember for sure.  I know they had a couple different plans to choose from.  I want to say it was around $1000 for the plan i picked maybe a little more but it was so worth it.  They do all the work and you just sit back and wait.  It was a long year of a battle but so work it cause i am now 140 pounds less!  Good luck!

my doctor office did a peer to peer and i was denied didn't receive the denial letter but was trying to get a head start on an appeal i have personal choice insurance..can anyone help me i was trying to get the band removed and revise to vsg

Did cal optima ever cover the procedure. That's what I have and starting out?

My process with Cigna was SO smooth! I recently got approved and am having the surgery on March 18th. I went to my PCP for the 3 month weight management program. Luckily my PCP was very understanding of the irrational insurance requirements. So I first weighed in with my clothes on and for each month visit I was maybe a pound or two down. By the last one I was under 40BMI so we just tweaked the weight up a little bit so it wouldn't cause an insurance issue. Just make sure you have 4 visits - each at least 30 days apart. My weight was up and down during those visits, and that didn't matter. My PCP and I didn't talk much about eating and exercise since I had done it all before. She wrote down some things about reduced calories and increased activity on what she submitted to Cigna. Basically, just have a conversation with your PCP about exactly what your insurance requires and see if he/she is willing to work with you to make it work. I think this is pretty common. The doctors and my surgeon's office were also really familiar with it. The only requirement I had was that I couldn't gain more than 10 pounds from starting their program. But they were totally understanding about me not being able to lose any weight before getting approved by insurance.  My biggest recommendation is just to get a copy of Cigna's bariatric surgery coverage policy and bring it to all of your doctors to use as a checklist. If you have everything on the list, it won't be a problem at all. Hope that helps! Oh - also, Cigna approved me within a week of getting the paperwork, which was nice.