Weight Loss Surgery Requirements: Making Medically Supervised Diets More Likely to Be Approved

When I first made the decision to undergo weight loss surgery in order to finally get rid of my excess weight and keep it off, I was anxious to get the surgery completed and get started with my new life. Unfortunately there were an abundance of necessary tests in order to ensure I was healthy enough to undergo such a serious surgery. I passed all the tests with flying colors, but the thing that gave me the most trouble was the 6-month medically supervised diet that my insurance required before my surgery could be approved. Most insurances require some type of diet prior to approval, whether it's 3, 6 or even 12 months. The following tips will help you to ensure that all medically supervised diet requirements are met so that you're not denied, like I was the first time I tried.

Consecutive means consecutive - I visited my doctor for months in hopes of having my surgery approved, but because my 6th month's visit was June 30th and my follow up visit wasn't until August 17, my surgery was not approved by my insurance. The reason they gave was that the 6-month medically supervised diet requirements hadn't been met because all my visits weren't consecutive. Some insurances are stricter than others when it comes to the diet, so in order to be safe, simply schedule your visits each and every month, even if you have to reschedule something else that may interfere with your getting in for a weigh-in.

Proper documentation - another problem with most medically supervised diets is the fact that insurances want the notes about the diet to be only about diet and exercise. They don't want to hear that you discussed headaches or neck pain or any other problems with your doctor during the same visit. Even if you do discuss other issues while at your monthly weigh-ins, be sure that your doctor knows that other issues should not be but on the diet notes that your surgical weight loss clinic will receive to submit to your insurance.

Late is sometimes better than early - when it comes to scheduling appointments, some insurance companies can get really picky, even if you're seeing your doctor for follow-ups on a monthly basis. For instance, if your first appointment is on May 24th and you're due to return in a month, the scheduler may try to give you an appointment for June 21st or 22nd, which is technically one month later, yet insurances like it to be 30 full days or more apart. Scheduling the next appointment for June 24th or even June 25th, while it appears quite trivial, will satisfy most insurance companies.

Actually stick to the program - obviously you've had some problems with weight loss in the past or you wouldn't have made it this far in the surgical weight loss program. Despite this fact, it would certainly help your case if you make some effort to actually follow your doctor's diet and weight loss program. Even if you lose very little or no weight at all, that's acceptable, but some pre-surgical patients use the period prior to surgery as a "license to eat" and actually gain weight. Most insurances will still approve the surgery in such a case provided all other requirements are met, but again, some insurance companies are stricter than others and may deny you, which is why you should take the diet seriously. If you feel the need to overeat prior to surgery then perhaps you aren't quite ready to take such an important step. Weight loss surgery takes a great deal of work and is definitely no free ride, so if you aren't fully prepared, you might be setting yourself up for failure.

I have a friend who had weight loss surgery through another hospital in my area, and her medically supervised diet was a breeze. This was due to the fact that she didn't have to go to her PCP, but instead went to a clinic affiliated with the hospital, and the clinic specialized in medically supervised diets for pre-surgical weight loss patients. Therefore, these doctors knew exactly how to document, set up appointments, etc. so that the insurance would not question whether or not the requirements had clearly been met. Unfortunately not everyone's medically supervised diet is going to be as easy as my friend's was, but by following the previous tips, you should be able to get everything easily accomplished so you can get your surgery as soon as possible and start your new healthier life.