6 consecutive months of non-surgical weight loss documentation?
Ok, now I'm getting nervous that I may be stumbling onto my first hang up in getting the revision from the band to the DS approved.
I know for my lap-band to be covered, I had to have 6 consecutive months of documented weight loss efforts. So, now I have to do that again because it's part of the criteria that must be met. I was thinking that because I've had the band for the past 20 months - that would be a "form of dieting" - if you will. Although I haven't been to my doctor each and every month, because I didn't need a fill every month. Doesn't the fact that I've had the restriction from the band count as a weight loss effort? Or, do I have to actually have like 6 months of weigh****chers records or something similar, like I did before my band?
Please give me your advice - soon, if possible. My orientation is Monday, and I hate to take the whole day off work, if I'm gonna have to wait at least 6 months anyway.
I was at the doctor for a fill in October, December, and January (missed November).
thanking you all in advance
I know for my lap-band to be covered, I had to have 6 consecutive months of documented weight loss efforts. So, now I have to do that again because it's part of the criteria that must be met. I was thinking that because I've had the band for the past 20 months - that would be a "form of dieting" - if you will. Although I haven't been to my doctor each and every month, because I didn't need a fill every month. Doesn't the fact that I've had the restriction from the band count as a weight loss effort? Or, do I have to actually have like 6 months of weigh****chers records or something similar, like I did before my band?
Please give me your advice - soon, if possible. My orientation is Monday, and I hate to take the whole day off work, if I'm gonna have to wait at least 6 months anyway.
I was at the doctor for a fill in October, December, and January (missed November).
thanking you all in advance
RNY on 12/27/17
Yes, I too have a lap band but am considering a revision to a VSG. That is my question as well, since I have had my lap band since 04-04-08, does that count as a weight loss effort? I will find out what my doctor's office has to say, my lst appoint ment is next Monday 2-16. I have BCBS Federal. What insurance do you have? I will be sure to let you know what they told me.
Thanks for your replies. When I called my ins. co. and asked them the criteria for WLS - I did tell them that I already had the Lap-band - she said that I need 6 consecutive months of attempted weight loss SINCE MY BAND. So, my question is -- doesn't the 20 months of having the band count as "attempted weight loss"? I don't see how it wouldn't, but I'm not sure how they perceive it. I have BCBS of Michigan. I would love to know if anyone else has anymore information. And, please do let me know what you find out about your BCBS Federal policy requirements. Good luck to you!