Question:
What do I do with the 6 mo dr. supervised diet?
I am 5'4" tall, have a BMI of 39.6 and insurance wants me to have a 6 mo supervised diet? What does that mean and can I shorten it at all? If I loose to much weight will I qualify still? anyone got any ideas? What did you do? Anxious and concerned. — ambergirl (posted on August 23, 2009)
August 23, 2009
I too had to do the 6 month supervised diet. It is actually 7 months
because the first visit does not count. My surgeon or insurance required I
actually lose weight during the 6 months, the insurance just required it
before they would consider approving me for surgery. My surgeon had a form
created from insurance denials, he gave me a copy and asked that I take it
to my pcp. My pcp filled out a copy at each visit, he documented what I was
trying to do to lose wieght, count calories, walk etc. At the end of the
7th month, I returned all my forms to my wls, his insurance clerk submitted
them to my insurance online and we approval within 5 minutes, literally. I
would suggest you find out what your surgeon requires during the pre diet.
Some do require a certain percentage of wieght loss. Also some insurnace
companies require you lose a certain amount to "prove" you are
ready for surgery. Best of luck to you!!
— fillisg
August 23, 2009
It means you have to be under a doctor care for 6 months such as a
dietician. You will see her once a month she will take your weightat each
visit and talk to you about your eating habits. She will also get you
prepared for the surgery you decide to have. My dietician told me it did
not matter if i lost weight as long as i didn't gain any before I was
approved.
I have BCBS Insurance and they just went from 6 months to 3 moths
supervised doctor care. Thank God!! Check with your insurance provider to
confirm. Good To You.
— sjh921
August 23, 2009
I am also 5'4'' tall with a BMI of 40 and my insurance co. (Pomco) required
me to be on a 6 month supervised diet which initially I didn't mind because
I thought if I could be monitored by a dietician than maybe I could really
learn some good tips and maybe loose weight on my own without having to
have gastric bypass. But I will be going for my 5th visit soon and haven't
seen the dietician yet! All I do is get weighed in by a nurse and they just
give you ideas what to eat and that's about it. The entire weigh-in appt.
lasts about 10 min. I have actually gained about 10 lbs. since my first
weigh-in because I allow myself to eat whatever I want and justifying it by
telling myself that I am going to enjoy it because I'll be having surgery
in Oct. So this stipulation by my insurance com. is back firing for me.
Thank God they don't require that I have to loose a certain amount of
weight. But don't worry if you loose weight during your 6 months of
monitoring , I don't think that will stop them from approving your surgery.
But if you are that worried, ask the staff at your doctors office, they
know all the ins and outs of these insurance companies. Good luck.
— linjim
August 23, 2009
The 6 mo supervised weight loss is usually two-fold. It will help to shrink
the liver to make it easier and safer to perform your surgery and it will
let the insurance company know whether or not you are a compliant patient
that's willing to follow your doctor's orders over a long term (6 months).
Your weight as far as the insurance company goes is at the BEGINNING of
your 6 month weight loss. They don't care how much weight you loose you
will still be able to have your surgery. Most obese patients can take
weight off they just can't keep it off long term.
I followed the weight loss program and lost about 20 pounds before my
surgery. My insurance company required at least 15 pounds. I didn't do it
until the two months before my surgery because not only did you have to
loose the weight you had to keep it off and that was the easiest way for me
to make sure that I did it.
Bob
— rkurquhart
August 23, 2009
u use this time to prepare ourself for the new life u will be
experiencing.Get the carb monkey off your back by cutting them from your
food intake.Stop drinking carbonated beverages,and focus on the positive
things that are ahead for u.There are many things post op that u will have
to deal with and the craving for carbs won;t be one of them if u elimanate
them pre op.U very possibly could even loose some lbs .good luck and keep
asking questions.
— Bette Drecktrah
August 24, 2009
Along with all the other posts. There is one thing I would like to
suggest. Find someone or someplace that will give you some support. You're
about to radically change your life. You need this time to learn how to eat
properly with the proper ratio of protein, good carbs, and vegies/fruits.
Also, give you support on how to deal with emotional issues that plague
people like us. I'm thinking like Weight Watchers, Overeaters Anom, Tops,
the support groups at the center that you are going to, etc.
— Kathleen W.
August 24, 2009
My insurance plainly states on a paper that was issued by my surgeon that
if I lost 10% or more of my initial weight in 6 months, I would be
ineligible for the surgery. I am going on my 5th month now and have lost
3-4 pounds here and there and gained it back. I was put on insulin and was
told it would make me gain weight so I am battling that too to try to lose
a little weight. My surgeon has me go on 2 week liquid diet - opti fast -
two weeks before surgery to shrink my liver. So hopefully i will satisfy
the insurance company and I have it in writing that if I lose too much,
they will deny me.
— Ambria
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