Required Documentation Before Surgery

Hi All - just curious what kind of documentation you all needed for your insurance when it came to a "medically supervised weight management program"?  I have Cigna that requires 3 months of that, but I know most insurance companies require it. Just wondering what level of detail your documentation had? Was it just doctor's notes with your weight and stating what diet and exercise plan you were on or was it more detailed with a food and exercise diary? 

I did not have to do a supervised diet.

I would check with your insurance company, though, to make sure you understand exactly what they require.  Don't rely on anyone here to tell you, or on your doctor to know.  Make sure you know so they don't have an excuse to deny your surgery.

I have Aetna and so do some people in the practice where I had my surgery was but we had VERY different experiences. Because it has a lot to do with your individual policy and how it is written. 

My thought was, based on some of the things I have read here, what was required of me was fairly minimal, but VERY specific. I had to see my doctor every 30 days, but if I saw him on the 1st and 31st, it did not count. So I had to 'play the game' of going into the next month twice and learned to schedule on the 2nd so that I could see him on the 30th day and be okay. 

The records of my weight went back to the day of my birth, I am not one of those that got fat after a baby or traumatic event, so I did not worry about whatever length of time they wanted. 

I did have to show that I did not gain a certain percentage (5 maybe?) during the 5 months of pre-op time, but did not have to lose a specific amount.

The requirements for the psych eval were not from my insurance, but from my surgeon. My surgeon required me to see the nutritionist at LEAST monthly, I normally saw her every 3 weeks.  Insurance required me to have a pre-op appt with her, not a certain number, as the surgeon visits are what they tracked my weight from. 

So while it is important to know, from the insurance company directly, exactly what is required of you...be sure you are also CRYSTAL CLEAR on what the surgeon requires on top of that. 

 

 

Hi

I have medicare and bcbs.

My advocate had me fill out forms. One of the forms had to do with the weight loss programs I had tried. Names, dates, pounds lost. Example: Weigh****chers, Adkins diet.

Do you have an advocate in your program? 

 

I have Cigna and had to do a 3 month supervised diet with a nutritionist. Also, make sure each appt is 30 days apart. It actually will be more like 4 months when all said and done. They will denie you if it's not.