Challenging Tuffts "I CAN CHANGE" program.

I was planning to self pay for my RNY, until my boss told me he was switching to an insurance that will cover RNY. That insurance is Tuffs. The have a manadatory" I CAN CHANGE"  program  that is six months, prior to any approval.I was wondering if anyone has ever  tried to appeal that program. I have been to numerous dietician and have been followed by my PCP for wieght loss, so Imhoping they will count some of that. Anyone got any advice???

Jonnalee

Hello-
I do not know specifically about the Tuffts 'I CAN CHANGE' program, but I do know that many insurance companies out there require participation in a 6 month program like this one. My background for the last several years has been running a bariatric practice and I have tried to overcome this challenge for many patients. I have not seen one case where an in an insurance company required participation in a specific program like this and accepts other documentation instead. That being said, you should certainly try it out and see what they say. I'd recommend calling the insurance and asking if they would considering accepting 6 consecutive months of notes from your PCP and dietitian.

Best of luck to you!
Billie