How did you do your 6 mo. of medically supervised WL if your insurance required it?

Diamondhorse
on 10/4/10 10:53 am
If your insurance requires you to do a 6 mo. program of medically supervised weight loss, how did you do it?  Does your insurance cover non-surgical weight loss programs?  If not, did you have to pay out of pocket for whatever program you did?  I'm thinking of using my PCP, but I'm sure that he'll code it weight loss and it won't be covered, thus I will be paying out of pocket.   
kurn07
on 10/4/10 12:42 pm

Insurance did not cover. 60 bucks a pop.

Diamondhorse
on 10/4/10 12:57 pm
On October 4, 2010 at 7:42 PM Pacific Time, kurn07 wrote:

Insurance did not cover. 60 bucks a pop.

Did you do it with your PCP?
Nan2008
on 10/5/10 12:39 pm - Midland, MI
Forgot to answer this part of it. 

My insurance paid the $20 co pay for the office visit. 

Nan

HW 300
/ SW 280 / CW 138 /
GW 140
Hit Goal 4/2/2010

        
kurn07
on 10/5/10 2:06 pm
On October 4, 2010 at 7:57 PM Pacific Time, Diamondhorse wrote:
On October 4, 2010 at 7:42 PM Pacific Time, kurn07 wrote:

Insurance did not cover. 60 bucks a pop.

Did you do it with your PCP?
I tried to use my primary, she didn't do medically supervised diets. She then sent me to a dietician. Luckily I only went to her once before I found out this would not count either. I then called my surgeons office and they recommended a office that they work closely with. This office knew what documentation had to be completed and everything. I ended up a month behind, but I'm on track now and on my 5th month. At first I was very upset about having to wait for the surgery, now I love it. I've lost 40 pound so far, was able to research way more and be more informed about my decision, and I started lurking here and learning from those that have been through the trenches.
Michgurl10
on 10/4/10 2:24 pm - Ann Arbor, MI
My insurance company covers non-surgical weight loss programs. I see a dietician at a local hospital. My lazy PCP is making my dietician fill out the 6 months of visits and progress notes and then she is gonna sign them. My surgeon's office sent me in the info package about their program, 6 months worth of blank forms for the PCP to fill out plus a sample sheet of how to fill it out.
When it comes time to send the stuff to the Ins. company for auth., the surgeons office sends that stuff in, they deal with it all the time and should know what to do.

Do you have a surgeon picked out, if so contact them and ask for info on their program and they may be able to answer some of your questions on that, mine was very helpful. Now some of the hospitals in my area won't even see you for a consultation till you have finshed your 6 months of diet supervision.
Karen P.
on 10/5/10 1:57 am
I was scheduled for surgery tomorrow and just found out that my insurance is denying coverage.  I've been going thru a 6 month nutrition program with a registered dietician and the insurance company said that the registered dietician didn't count as "medically supervised" because notes of my progress have to me contained within my medical history with an MD and that can't include my bariatric surgeon.  I'm just disgusted!!!  I hope your insurance isn't as strict or has loop holes.  I'm going to appeal the decision, but I've been working toward this day for over 8 months only to be denied.  Ugh.
mrsconrad
on 10/5/10 5:54 am - Steger, IL
Karen- who is your insurer...  I am going through the same type of thing with aetna right now...
Nan2008
on 10/5/10 12:38 pm, edited 10/5/10 12:41 pm - Midland, MI

You must use your PCP.  Most insurances do not recognize any weight loss program other than one that is documented in your physician's notes for their 6 month medically supervised diet.  You go to your PCP, state you are there for weight loss and make sure the doctor is noting your weight, height, bmi in your office notes.  Also mine noted behavior modifications and documentation of following a low calorie diet and also noted my exercise regimen.
 I have Aetna and was denied at first for this exact reason....stating I did not have 6 months supervised diet.  I had 8 months of weigh****chers documented, but I knew this didn't count even though I was going weekly for 8 months.  My surgeon's office submitted my paperwork thinking WW counted since it was more than 6 months but Aetna denied.  I was just finishin up their  3 month multidisciplinary program which was all documented by my pcp and I filed an appeal and was then approved.

Bottom line...."m'edically supervised diet" means your physician.

Hope this helps...good luck to you

Nan

Nan

HW 300
/ SW 280 / CW 138 /
GW 140
Hit Goal 4/2/2010

        
sophielyn
on 10/9/10 8:35 am

Nan, did you have to do 6 mos medically supervised plus 3 mos multidisciplinary program?

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