Insurance & Dieting

I just going documentation of me my dieting..

The only thing that the doctor was able to give me me information on weight and the drug I was using for 4 months.

Do you think I should start with someone else that can give me more than that type of documentation for BCBSIL?

Any thoughts would help

BCBS/IL just changed their requirements as of 07/01/09.  Now you only have to do a 3-month supervised diet program instead of the 6-month.  Per their Medical Policy the diet program has to consist of nutritional and behavioral counseling.  The way they determine if this has been achieved is to review the notes your surgeon submits to the insurance.  A simply copy of medical records may not work if it doesn't provide enough detail.  At least that's the way it worked when my doc submitted for my predetermination of benefits.  Each month we had to attend our surgeon's class which was led by his R.N., a registered dietician and an exercise physiologist.  Each of them counseled us one-on-one as well as to the group and they each gave us goals to work on for the next month, we had assignments to incorporate behavior changes, etc.  Then it was reviewed the following month and they made their notes on whether we achieved them, etc.  There was also a psyche evaluation by a psychologist that had to be conducted as well.  We weighed in each month also.  Even though I had to do 6-months of this I am glad because I learned so much more that is helping me to lead a healthier life now and make the most out of my surgery.  (I had RNY gastric bypass.)  You can find all the facts about what you need to do on the BCBS/IL website under the provider's tab and then under the Library tab, then Medical Policies.  I think it was listed under "surgery for morbid obesity", pg. 17 or so.  Good luck to you!