Insurance Approval - 6 Month Supervised Diet Documentation

My Bariatric surgeon is submitting my request for approval tomorrow. I'm hoping all goes well as my insurance requires a 6 month supervised diet and we are using 3 months with my primary care physician along with 3 months at bariatric surgeon office (with nutritionist). The case manager at Bariatric Resorces (UnitedHealthCare) said that would count, but the notes my primary made aren't too explicit (though he did also complete a form for me). I have done EVERYTHING asked by the bariatric surgeon - exercising, revised my eating, taking all the proper supplements, no caffeine and no liquor. I lost 20 pounds and am now at BMI 35.5, so the surgeon told me to hold at that (I suppose it is good practice for maintenance later.) I have co-morbidities, so my main worry is the 6 month requirement.

Hoping for for a quick approval so I can have surgery in the next month. I want to be far enough away from my annual 2 week trip to Aruba in early June so I have my routine figured out. Anybody have any feedback on how strict insurance companies usually are on the 6 month documentation? The referral person at the surgeons office seems to think it will work.

Good luck with your approval.

I went through a Diabetes program through my hospital and we used their notes for my 6 month supervised diet program.  The insurance company took that, but I can't remember if it was United Healthcare of Blue Cross Blue Shield at that time.

Keep us updated!!

Linda

My insurance didn't require a 6 month diet but my WLS Dr required 12 training sessions, 2 per month, so I had 6 months anyway before they would submit for approval.  My Dr office knew exactly what each insurance would and wouldn't do so I bet if they tell you if will work, it will.

Good luck.  Keep us posted!!!

Mine required a 6 months worth of documented diet... What my pcp submitted was in here medical necessity letter that talked about the different diets that I had tried ... That's it, she just wrote it down and signed it. 2 weeks in Aruba !!!!!! So Jealous jk

Good luck to you

Thanks for the feedback.  We have a timeshare there.  Fairly inexpensive in June (except for flights).

Welcome to our LW Board!!!!  Congrats and wanting to make your life better!!! 

My PCP monitored me the whole 6 months. I did make several visits to see my Surgeon during that time.   I think it's basically a list of things we have tried (which I gave him), states what kid of diet (mine was 2000 calories) I was currently on and my monthly weigh ins.  He did stress I had to come the same time each month and I wasn't allowed to gain.  I only lost 1 pound each month and I was really trying. 

Usually the referral person at the surgeons offices know what they are doing.  It's their job to know.

Approved!  I received the word yesterday - hoping to get a date today!  I had talked myself into assuming that the insurance company would want 2-3 months more documentation, but they surprised me.