Question:
A medical necessity letter or 6 mos of Dr Suprvise diet?

I'm going to see my pcp tomorrow for the first of six long months on another diet. They want this one to be SUPERVISED. I wonder if my pcp could just write me a letter saying that I have been dieting eversince she met me (5yrs)    — lrgsgt-o9 (posted on July 20, 2009)

July 20, 2009
According to my doctor, it would be illegal for her to do that. The six month supervised diet(s) must have monthly visits recorded, along with weight, diet currently following (you don't have to stay on the same diet for the whole six months), exercise program you're doing, any behavior modifications you are practicing, drugs you are taking, blood pressure and records of any other co-morbidities, like high lipidemia, cholesteral, triglycerides, arthritis, joint problems, etc. And AFTER all of that, she will STILL need to write a letter of medical necessity, using all of this information to formulate the letter. It can include past weights from when you first saw her, and past lab results that continue to present concerns, but for her to just try to say that you've been dieting for the past five years without monthly records to prove it will only result in immediate denial.
   — Erica Alikchihoo

July 21, 2009
What you are trying to accomplish here is to prove to the insurance company that the surgery is deemed medically necessary. So in order to do that, your doctor needs to gather all the info regarding your health. Co-morbidities include: sleep apnea,gerd, diabetes, high cholesterol, heart disease. A co-morbitity is any condition that is considered life threatening. Sleep apnea you can stop breathing, gerd can cause cancer in your esophagus. So the supervised diet could be any attempt at weight watchers, jenny craig, nutrisystem, any kind of diet plan, pills, etc. that you might have the proof of going or doing. I had all of my stamped records from weight watchers and a letter from jenny craig stating that I was a member and I didn't loose the normal amount of weight given the normal person would. If put in that I was insulin resistant, pre diabetic. So I don't think your doctor can just write a letter. It has to be noted in your chart all of your issues, and weight lose attempts. I was denied the first time, due to lack of information. So make sure you have all the information you need to put in your chart. Have you saved all of your weight lose attempt records. That would be a plus. Hope this helped.
   — Kristy

July 21, 2009
No way around it unfortunately. I have my last appointment on August 3. I have to say when I first heard I had to go on a monthly basis even though my PCP has been seeing me for medical issues related to my weight for 5 years I was disgruntled to say the least. But just a bit of encouragement,it has gone faster than I first thought. It's a good time to research and read about the surgery.
   — Barbi M.

July 22, 2009
I don't think you would find a doctor to be that dishonest. And if you did would you have any respect for him or her. Do the right thing because it is the right thing to do!
   — sallie H.

July 23, 2009
I know the six months seem long, but it goes by fast. It will also give you time to attend support groups and get mentally and even physically prepared for surgery. I did the six months and i'm waiting on a date. It seemed like time flew by.
   — Meeky