NJ Direct

Hey Everyone, I was just wondering if anyone has recently been approved for the RNY Procedure through NJ DIrect.  

Main question is-

Do they still require the 6mo supervised weight loss??

and do they require a psych?

-Ryan 

Hi Ryan,
I have NJ Direct 15, and I was approved back in February with no problems.
Yes, they do require a 6 mo. supervised  "monthly weigh in"  through your primary care Dr. or it can be done through your surgeon. (mine was too far away, so I did it through my primary Dr.)
They didn't require me to have a psych evaule, but my RNY surgeon did.
Personally I think it's a good idea, because there are a lot of head games that you go through after the surgery.  I only had to see him one time though, and the insurance covered it.
My surgeon also required that I see a cardiologist, pulmonologist, have an endoscopy, and colonoscopy, have tons of blood work, attend a weight loss seminar,  and see a nutritionist.  The nutritionist was not covered through insurance, and it cost me $500.00 out of pocket.  You get 12 visits with them (at least I did with mine) and it was well worth it.  They give you tons of information that is very valuable, and I still refer back to my notebook when needed.
I know it seems like a lot to do, but it really is in your best interest.
Good luck with your journey, and you'll be so happy with your after surgery results. I know I am.
It was the best thing I ever did for myself.
Karen

 Karen thanks for the reply.

When you needed the 6months, what did you ask your pcp?  I have been going to the same physician for a year now at least 1x a month and he weighs me every time.  Is this all i will need?

Sorry to say Ryan, but my surgeon said it had to start from when I first went to him.
All the other times like you, being weighed in the past, didn't count.  That really sucked!!
After I did do my 6 months, my surgeons office gave me 6 forms for my pcp to fill out for each month. (They said they thought it was in the package they gave me, but it wasn't)
See if your surgeon has that form and run off copies, that way it can be filled out each time you go, instead of all at once at the end.
I first met my surgeon on June 30th, and by the time I was done everything I had to do, I got a date for Feb. 24th.   All in all, it took me 8 months from start to finish.
Believe it or not though, the time really did fly by.
Karen

Yes they require a 6month diet..also it's good to go to the psyc and have that approval in your packet...  alot of surgeons like for their patients to do the evaluation to avoid delaysof approval..
All you have to do is tell your doctor what your doing to lose weight.and have them document it for 6 months have him take your weight and tell him what your doing daily and thats it..

I have NJ Direct 10.  Everything was approved.  You can even find nutritionists who are in network and psychs who are in network.  it may not be the ones associated with your surgeon's office, but there ARE both nuts and psychs who have bariatric experience and will be covered.  the one's recommended by my surgeon were not, so I went and found ones that were!


Yes, 6 months was required.  I just went once a month, did blood work and weighed in.  we discussed how I was doing with my weight, etc.  after 6 mo, she wrote a letter and included copies of her notes from our visits.

pretty painless (compared to the actual surgery)  LoL