Looking for tips and advice

I have BCBSAZ.  I have a copy of the written policy and it is pretty standard - 6 months med supv multi discipline diet and exercise program, nut visit, psyc eval, etc.

I just started by 6 months.  Not enough documentation from decades of other attemps.

What can I do to help make sure I have all of my ducks in a row?  What pitfalls do I need to avoid?

I just saw my PCP and she is sending 5 years of medical history to my surgeon, she is also writing a letter.  I will see my endo in 2 weeks and she will do the same thing.

What in your experience do they want from the nut?  My endo has one in her office, but I want to make for sure FOR SURE that I get what I need.

My surgeons office offeres a multi discipline program.  Will the insurance frown on the surgeons' office doing this program with me?  Would I be better off having a different office do this?  Since they have so much experience doing this, I thought it would be best?  Would 2 physicians working on this with me do any more good?

Sorry so long!  I was denied 2 years ago with a different insurance company and I don't want to make that mistake again.

Thanks so much for your help!
Julie

Hello,
I can't answer your questions totally b/c I am in the same boat you are however I am doing the 6 month diet with my surgeons office.  I see their nut and dr once per month.  The nut looks over my food journals and writes down my progress and excercise.  I have been told that excercise is very important.  Another person told me to go 7 times even though it is a 6 month diet since the first month you are just starting so I am not sure if it counts or not so I am just doing it anyway.  Thursday is my 7th visit since April.  You have to go once each month or you have to start all over.  Not once every 30 days.  I chose to do it with the surgeons office b/c I thought they would know what I need since they are the ones sending it in for my approval.  If I find anything else out I will let you know.  Good Luck

Hi Julie-
I suggest that you do the multidisiplinary progam through your surgeon's office. They know best how to document the 6 mo WLP and often times the Primary Care Doctor will miss something small and then you get denied. Stick with the program your surgeon offers!
Best of luck to you!
Billie

Do I need multiple visits with the dietician?  I have had more than one person tell me I need them to review my food journals, but my coverage did not specifically list that, only that I had to meet with a dietician as part of my qualification.

Hi Julie-
No you do not have to meet with the dietician every month, but it does look really good on your documentation for the 6 month weight loss program. The key is that you HAVE to meet with the doctor, either you PCP or the Surgeon or another doctor in your surgeons office who does these types of appointments. You have to have on visit in each calendar month, don't skip any months.