Weight Study

What's the point of the weight study?  Does the insurance company want to prove you are serious and lose some weight during it or do they want to prove you can't lose weight? I suspect it is just a speed bump to try to discourage...but officially what's the reason? The lady (insurance specialist???) I spoke with at the surgeons office seemed to think because of my BMI and other health issues I might not have to do one...but I want to be prepared. Thnx, Dawn

I think it's a combination of those things.  I think they want to know that there's a reason for them to shell out the money.  I guess I can't blame them.  But, with most surgeries, there are typically insurance guidelines you have to meet.  I had problems with my tonsils all my life.  But, in my late 20's it got really bad and once ended up on the ER at about 3am because I was in such pain.  Come to find out, my insurer at that time required documentation that I had been treated 3 times in a year for tonsilitis before they would cover removing them.  Every insurance is different about their requirements for WLS but the standard seems to be a 6 month dr. supervised diet and psych evaluation.  Did your surgeon's office provide you with your insurer's requirements?  If not, call your insurer for it.  Then you will know their guidelines. With my insurer, if you had a BMI below 40 you had to have comorbidities.  If your BMI was over 40, you didn't.  But, regardless of comorbidities, still had to have 6 month dr. supervised diet.  So... get the requirements for surgery from your insurance company.  That will give you a definitive answer about what you have to do on your end.  But, I will say that even if you have to do a dr. supervised diet, don't sweat it.  It goes by faster than you would think if you just get started and do it.

Will documentation of prior weight loss attempts from your PCP's office work?

I am hoping so.  They haven't requested it yet but the surgeon's office warned me they might. I am just confused on what the point of it is.

The insurance companies claim it is to show that you have made a serious to effort to diet. I think it's just another stall tactic on their part and they are hoping it will discourage people. My PCP had years of documented diet attempts in my file. We also had the fact that he had put me on Meridia 6 months prior to my application for surgery. I would call the customer service number on your insurance card and ask them exactly what the requirements are. You will get all of this info from the clinic too but making contact with your own insurance company, I think, lets them know you are serious and you are not going to go away. I hope everything goes smoothly and you are on the road to approval very soon.

Hey Dawn, this is yet another Insurance jump through the hoop thingy. Just about everyone has to, it is really no biggie, it is just takes time. But I figured I had waited this long to do something what was a few more months, it that is what it took. I learned real quick, if you do as they say, things will happen alot sooner. I hope this helps. Cheryl