6 month diet

I just spoke with my insurance company today (Blue Cross Blue Shield) and they said I have to have to be on a diet for 6 months with a doctor's supervision. I have heard a lot of horror stories about insurance companies (especially bcbs) and was wondering if there is anything special I need to do. Do I need to keep a journal of everything I eat, everytime I exercise? Should I try more than one diet? Is there anything specific my doctor needs to keep track of? Are there special forms they need to be on? I just want to try to be one step ahead. I know my mom did all of this stuff for her gastric bypass, the insurance (Cigna) kept sending stuff back, saying they needed more, which lasted 4 years. Any info will be helpful. I have my first doctor's appointment next week. Thanks.  Jamie

Jamie,   I would call BCBS back and have them send you a detailed list as to what the doctor needs to do for you and what you need to do.   I had BCBS and didn't have any problem getting approved.  But I also went in to my doctors office with a list of all the diets I had tried over the years, how long I was on them, how much weight I lost if any, how long I kept it off and what not.  I think the more you can show them to prove you have been working hard for this and that you really need it the better off you will be. Good luck!

Your surgeons office should be very familiar with what the insurance company is looking for. I hadnt heard of BCBS requiring a 6 mo sup diet before... wonder if they recently changed the policy? I dont know what they need because I hadnt heard of anybody being required but with Cigna you had to go to a physician once a month for 6 months and get weighed and discuss your eating etc... basically you didnt want to lose too much weight but you did NOT want to gain weight... I think most people would try and lose a extremely minimum amount of weight... a pound or so... dont want to be too successful but then you want to show you are committed (double standard eh?). As for keeping a journal and exercise that would be between you and your Dr... I would say no.... I dont believe there is a set form but you could ask - I believe the office notes from your Dr would be sufficient.

Thanks guys! I appreciate all of your replies. I guess I am a little confused, am I supposed to go to my General Doctor or the Bariatric Surgeon for the 6 month diet?

I believe it depends on what type of plan you have with BCBS, I have seen different people saying different things about BCBS.  Some are approved fairly quickly and some it has taken awhile.  I don't know if it has to do with your plan, employer, or what you submit to them.  

I have BCBS of MN and had to do a 3 month program. All I had to do was meet with my nutritionist once a month for 3 months. The first meeting was about an hour and the other two were about 20 minutes. The first meeting we just talked about food issues, I told her what I ate, she suggested some ideas to me...yadda yadda yadda. Basicaly, the same stuff you talk about at any nutritionist appt. Then the other days I just checked in with her about how I was doing, was I able to follow the ideas she gave me, checked my weight.... It didnt matter if I gained (which I did) or lost weight as they submitted my original weight from the very beginning when they refiled my paperwork.  M.

I have BCBS as well and I just started my 6-month supervised weight loss last month. Of course my plan could be different than yours, but for me, I have to do the 6 months supervised by my primary doctor as well as a nutritionist, then to be approved I have to have a BMI over 40, 5 years' medical documentation of my weight, a letter of medical necessity from my primary doctor, all the notes from my nutritionist, etc. It's basically an exercise in compiling paperwork! I started with my primary doctor and told him what I wanted to do and what the insurance requirements were. Then I went to a nutritionist, and I will meet with both the nutritionist and primary doctor once per month for the next 6 months (just to have the 6 months documented). My nutritionist is forwarding all of her notes to my primary doctor's office so that he can keep the records together. In the meantime, I'm gathering info from every other doctor I've seen in the last 5 years. My primary doctor had me choose a bariatric surgeon and begin the process with their office, but they aren't quite ready for me yet. The bariatric facility won't really need to work with you until you've completed the 6 months. My facility asked me to contact them again at 4 months just to touch base, and then with insurance approval they will be ready to move me into surgery pretty quickly. As for keeping journals, I'm not sure. The BCBS policy I have didn't require it, but I'm doing it anyway for my nutritionist. My strategy is to have everything documented and compiled as much as possible so that they have no choice but to approve me! Best of luck! Let's pray these 6 months fly by!

Thank you so very much! You have been a big help to me. It is nice to hear from someone with the same insurance so I know what I am up against. The best of luck to you too. I hope you keep me posted on how everything is going for you.

Everyone's insurance policy is different and sometimes even the medical policies they use are different you wont know for sure untill you meet with you're dr and most like they will do a predetermination of benefits. Then you'll know exactly what you have to do... If there is a medically supervised diet needed then that means you have to check in atleast once a month for six consecutive months with a nutritionist usually most hospitals that have bariatric programs have classes set up for this you just check in and its kind of like weigh****chers except with a real nutritionist... regardless of what you may be told dont stress out you dont need to lose a pound for it to count you just have to show up, dont be too disapointed i know it's frustrating but some health insurance companies actually require a whole year so it could be worse... before you know it it will be over although who knows you may not even have to do that.