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Insurance Discuss insurance topics for the gastric bypass and Lap Band® operations.

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Old 06-22-2008, 06:32 PM   #1 (permalink)
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Default PCP vs. specialist

So, there are some reknowned bariatric surgery centers where I live. Thus far I've been meeting with my PCP and doing Weight Watchers as my supervised diet plan (and have lost some weight this way). I thought perhaps this wouldn't count with my insurance and they'd make me go through the bariatric center for this whole 6 month stuff, where they have formalized nutrition counseling, etc. Does anyone know if it matters? My PCP said she's gotten everyone approved that she's referred for surgery and didn't think it would be a problem to continue seeing her the whole time for my 6 visits.

P.S. I am aware that I will need to meet with a nutritionist regarding before & after surgery, but I'm really just referring to the actual supervised diet itself.
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Old 06-22-2008, 06:47 PM   #2 (permalink)
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Do you know for sure you even need the six month supervised diet?

I didn't need to do any of that.. I went from asking about it with my PCP in late October, to having the surgery scheduled orig. for Dec.. moving to Jan when I had other medical issues crop up unrelated to weight & the surgery.
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Old 06-22-2008, 06:57 PM   #3 (permalink)
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please note that WW is not an approved superivsed diet recognized by insurance companies. They want a physician or nutritionist supervised diet if in fact they require one at all
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Old 06-22-2008, 07:01 PM   #4 (permalink)
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Quote:
Originally Posted by Godsblessedme View Post
please note that WW is not an approved superivsed diet recognized by insurance companies. They want a physician or nutritionist supervised diet if in fact they require one at all
Unless the WW is being supplemented with regular monthly PCP appointments, I would think?
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Wow Moments:
1) lost the crutch
2) ditched all meds..
3)"You've got Great Legs" compliment
4) No longer "Morbidly" Obese.. just "Obese"
5) Able to keep up with long legged fiancé on a 4+ mile walk


Gettin' hitched 10.11.08
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Old 06-22-2008, 08:46 PM   #5 (permalink)
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Yes, I did get that info from my insurance company that I need the 6 month diet, but they didn't get into specifics and when I called I was really calling just to find out if the surgery is covered.

My PCP asked me to see her once a month for 6 months for the supervised diet, while doing WW. We talked about exercise and diet and what I'm doing. I don't think she's "doubting" me b/c I have lost weight so far. But there's actual conversation about what I'm doing to lose weight and change my habits.

Like I said, she has done this quite a bit, several of her patients, as well as some of her office staff, have had it and they only went to see her, never went to another "program". I guess I will find out more when I get to that seminar, though. My concern is that I have to start the 6 months over, even though I already got the ball rolling with my PCP. I would hope considering I've lost weight that they would count this as time for the 6 months, even if I transition to another, more formal nutrition program.
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Old 06-23-2008, 03:56 AM   #6 (permalink)
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sounds like you're in good hands and I doubt they'll make you do another six months, since this one is documented with your PCP..

Good luck
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LAP RNY 1/29/2008
Century Club 7/29/08- Six Month Surgiversary!
HW-317/CW-213/GW-135

Official Scale Whore # 1
Gym Rat Number One Hundred
PurplePolarBear

Wow Moments:
1) lost the crutch
2) ditched all meds..
3)"You've got Great Legs" compliment
4) No longer "Morbidly" Obese.. just "Obese"
5) Able to keep up with long legged fiancé on a 4+ mile walk


Gettin' hitched 10.11.08
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