Question on Physician-supervised 6 month program

Jenvee
on 8/22/07 3:09 am
I am just starting my journey into weight loss surgery and my insurance provider (Aetna) requires a 6 month nutrition and exercise program supervised by a Physician.   Can anyone tell me exactly what qualifies as a "Physician supervised" program?  I have participated in several attempts to lose weight (Nutrisystem, B12 shots, Weigh****chers, Gym Membership, etc.) but want to make sure that I am complying with the insurance company requirements. Any direction on this would be greatly appreciated.
quiltz
on 8/22/07 3:44 am - Phoenix, AZ
The best advice I can give, is ask the insurance company for their exact definition of what a 6 month program of nutrition and exercise means.  Will you have to use a nutritionist or would something like Weigh****chers work as long as you check in monthly with your pcp for documentation purposes?  Can the pcp give you suggested exercises or do you have to have a gym involved?  All too often you will see posts here where someone has done 6 months of preparation and the insurance company comes up with a loophole that you were "non-compliant" about.  If you get them to be specific at this hour you may save yourself lots of hassle later.
Jenvee
on 8/22/07 8:51 am

Thank you so much for your reply.

I called Aetna today per your suggestion and all they would tell me was what the Policy Bulletin read, not what it actually meant. I can see why so many are frustrated with this process.

If anyone out there has any experience with this, I would greatly appreciate knowing what worked for you.  Thanks!!

RayM
on 8/23/07 4:20 am - Surprise, AZ
That is pretty much the same run around I get from Aetna also.  I told them I can read the Policy myself.  It does not clearly state anything.
MARY OTU
on 8/27/07 2:03 am - PHOENIX, AZ
It has been my experience from the support groups and the Board that the 6 month Dr supervised program is across the board the same:  You will need 6 months (I did 7 just to be certain) of documented visits. These appoints should not be more that 30 days apart. Each visit that you go to during this 6 months (even if it is for the fu or something) you need to make sure that the Dr documents “Weight Loss Management” as the PRIMARY reason for the visit. It would be to your advantage to go to a DR experienced with this. Good luck, Mary
vickinicole
on 1/16/08 2:47 pm - Bryan, TX
very good info to know, thanks for posting this

~_~
Vicki
My weight loss blog: www.vickionline.com

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