6-12 month supervised diet............

Are we supposed to loose weight on the 6-12 month supervised diet required for insurance??

Its not like we have trouble losing weight and keeping it off right? LOL

I had my band in 2007, my insurance company didn't have this "rule." Since then I'm looking into revision and have discovered they added this policy. I lost a tiny bit of weight the first 3 months, I'm afraid I'm on my roller coaster upward now, does that mean insurance will deny me???

 
You don't have to lose weight on the supervised diet.  Here's what you need to do:

1) Make sure that you see your PCP every consecutive calendar month, not every 30 days.  For example, you can see her/him on January 31 and then on February 27 (27 days) but you can't wait until March 2 (30 days) to see them or else you have to start over.  You can see the doctor any time within the calendar month, so June 16 and July 12 is fine.

2) Make sure your doctor codes each visit so that your diet supervision is the primary reason for your visit.  You can have anything else done while you're at the visit, but the supervised diet has to be the primary reason for that visit.  The visit should include your vitals and your weight.

3) Your doctor is supposed to be couseling you on better eating habits.  It doesn't have to be complicated.  For example, my doctor started by explaining the benefits of protein, asking me what I ate for breakfast (carb fest!), then asking me to add protein to my breakfast.  She gave me examples (like an egg instead of a muffin).  The following month, she asked me how it was going, and asked me to add more protein to my lunch (adding chicken to my salad; salad instead of sandwich, etc.).  It went on like that for six months.  Simple.

This is just a hoop.  Make sure that your doctor documents thoroughly what was discussed at the visit and the progress you're making in your eating.  Use the time to get all your pre-screening tests and to prep for the surgery.  It will fly by.

Good luck!

Awsome info!! Thanks a lot

I am doing the 3 month supervised diet with my Sugeon.  I was told that I have to go every 30-45 days.  That if I was there at 29 or 46 days the insurance company would deny me.  I do not have to lose any weight.

I would call your insurance to be sure.

Really really look into your insurance company because I read horror stories where people do not complete it correctly for them.  And they make them start over.  My surgeons office had a form to fill out for the PCP and they fill it out fully each visit.

Check with them, they always ask for height, (like you got smaller or taller) weight, and about thirty days in between appointments.  I made all my appointments on the 16th just so I wouldn't forget.  Most check for consistency.

Doctors weight loss requirments and insurance diets are separate things.
Good luck! I'm in month 4 of 6. 
JJ

 FYI, the American Society of Bariatric and Metabolic Surgeons (ASBMS) recently issued a position statement saying that medically required weight loss prior to surgery is against the standard of care. It might help in appealing.

http://www.asmbs.org/Newsite07/resources/ASMBS%20Position%20 Statement%20on%20Preoperative%20Supervised%20Weight%20Loss%2 0Requirements.pdf

Nice, thanks

I think I gained 10 pounds over my 6 months PCP supervised diet. It was a pain, but I can say I made it through it and am having my DS on Tuesday. I had a lap band for 6 years and had it removed. They would not do a revision at the same time since I had so many issues. Good luck. I thought the 6 months would last forever, and I could tell you it flew by, but it didn't. Good luck!!

I had to document that I went every month for six months - I lost a little but not a lot.  Just make sure that you make appointments at the beginning of the month and not at the end. Especially around holidays.

If the doctor has to cancel an appointment and you need to re-schedule you may technically miss a month and need to start over.  My PCP said this happened with someone previously in her practice (but not a patient of hers).

Thank you all