BCBS MN-Two PCP's

 Hello I'm new to the boards. First off I'm sorry if this gets to be a long post.  A little background, I have been considering WLS for probably the last 10 years or so.  When I would discuss it with family and friends their reactions would immediately make me reconsider.  I've struggled with weight my entire life.  I finally had enough and looked into my insurance. It requires a 6 month medically-supervised attempt to lose weight.  Just my luck, my regular doctor retired the previous month. He had been one of the biggest advocates for me to consider surgery. I called the clinic/hospital he was from and just asked for the next available appointment.  I had no knowledge of what the other doctors were like, as I'd had the same doctor for the past 20 years. 

I started my 6 months knowing full well this was my last chance to prove to myself I could lose the weight on my own.  I did everything the doctor told me to do.  I followed the nutritionists recommendations.  During the third month, and a total of 3 pounds lost I was offended by this doctor.  He questioned my parenting skills because my boyfriend and I lived together and neither were interested in going the marriage route.  To my way of thinking, I'd rather be in a happy, loving relationship than have a piece of paper and be miserable, which is what I was in my previous marriage.  Compounding this my oldest son became very ill, he was the doctor with openings that day.  He misdiagnosed my son with a bladder infection, when in reality  his appendix was severely infected. If I hadn't gotten him to an ER when I did, it would have burst.  The surgeon told me I had angels watching out for my son, she had never seen one so severely infected that hadn't burst. 

Under no cir****tances was I going to go back to this doctor.  I decided to begin going to the PA-C that was on duty in the ER (a different hospital system) during my son's appendectomy.  I still believe she and his surgeon saved his life. 

Now I'm getting to my question... will my insurance BCBS MN count the total months between these two or will it start over with the new provider?  I go to my consultation next Monday (12), my first support group on Tuesday (13) and I finish my psychological evaluation on that Wednesday (14).  I'm ready for the surgery, emotionally and physically. I have a support system in place (which does not include anyone negative about the procedure in the past). I'm worried that my 6 months  will have to start over.  (I only had 5 consecutive months with my new provider and then I had a 2 month period in between visits, due to one of my children being sick, and then my PA-C's vacation).  I have the full support of my PA-C.  She feels this is the right choice for me. Also note, she was the first to find out I was insulin resistant, part of the reason that even when I'm doing everything right, I see little results. 

The exact wording of my insurance policy is:  The patient has participated in at least one medically-supervised attempt to lose weight within the past two years.  The medically-supervised weight loss attempt(s) must include six monthly medical visits over six consecutive months with all visits under the direction of a medical doctor (MD or DO), physician's assistant (PA), nurse practitioner (NP) clinical nurse specialist (CNS) or a registered dietitian supervised by an MD, DO, PA, NP or CNS.  The patient's participation in a structured weight loss regimen must be documented in the medical record by an attending physician who supervised the patient's progress.  A physician's notation, alone, is not sufficient documentation.  Documentation should include medical records indicating the patient's adherence to the current nutrition and exercise program and the provider's recommended changes to the nutrition and exercise program throughout the course of the medically supervised weight loss regimen. Such documentation is necessary to establish the patient's ability to comply with the dietary and lifestyle changes necessary for maintaining weight loss following surgery. 

Can anyone with some insurance knowledge translate that for me?  I know I have met all the other requirements.  Again, I don't want to have to wait another 6 months, I will if necessary, but I don't want to get my hopes up that I could possibly have the surgery in May or June and then find out it will be delayed that long.  

Thank you in advance!
Ashley

Yes, they can make you start the entire six months over again.  Check it out:

~~The medically-supervised weight loss attempt(s) must include six monthly medical visits over six consecutive months~~

I'd hold off on the psych eval, et****il you know for sure that you don't have to repeat the 6 months.  They may want something more recent six months from now.

Thanks for the reply, I do appreciate it! Maybe I just need to call my insurance company and ask, but at the same time I don't want to give them an "out".

Between the two providers I had 6 consecutive months (actually 8) just not 6 consecutive months with one provider.  Hence my concern.  I was under medical supervision however two different doctors during that period.  

Basically my question should have read, can your medically supervised weight loss attempt be "supervised" by two separate doctors?

 I had my consult today.  They don't believe it will matter that my medically supervised 6 month attempt to lose weight was "supervised" by two different PCP's.  Phew!  Once they receive my psych eval they will be submitting to my insurance.