Update

I haven't posted in a while b/c of some ongoing issues. Long story short, insurance company and my family doctor's office disagree on what 6 months is... my insurance company says a 6 month physician supervised weight loss plan without excessive breaks. But what I think they mean (CIGNA) is 6 consectutive office visits. My appointsments ended up being about 5 weeks apart so I have to start basically over.

I'm stuck between starting the whole dang 6 months over and just going ahead and applying to the UNC program and hoping they can work the insurance problem out.  I really wanted everything wrapped in a nice bow and ready for the hospital to send to the insurance for approval.  Anyway so if I start the 6 month program (really just 6 blood pressure, weight counseling and weigh checks), I'm looking at a June date.   I'm cleared by the psyc (but they want a follow up) and only need to do the nutritionist part b/4 I apply.

Overall... just confused.

That is nuts.. sounds like CIGNA has gone nuts!

Hi Gale,

I would agree that a 5 week break is not excessive. When I did my 6 month, it didn't matter when in each month, just that I saw them each month, so some months had 6 weeks between appointments and some 3 weeks. You can't always make it every 4.3 weeks with Dr's office scheduling, getting sick, travel, etc... I would contact CIGNA and ask for a copy of their guidelines for the 6 month visits. How to they define an excessive break because their are 4.3 weeks to each month... i.e., some months have 4 weeks and some have 5 weeks, it isn't out of a norm to have a 5 weeks break. What do they want? 

Next, I would contact UNC and ask them to see if they think it's viable to submit to insurance. 

I hope that it all works for you. I know that you want to have the surgery sooner than later and I really do understand it, but please know that your journey has already started. It doesn't wait to start when you have your surgery, you are already on your way.

Keep going!

 

With Medicare it is 6 months.  They mean one visit in each month, for 6 consecutive months.  They provide you with a sample of what the doctor has to document in his notes, and a very good explanation of what their 6 month consecutive diet means.  You should check with your ins to see if they have explicit instructions.

Theoretically my DH could have had an appt the 30th of 1 month and the 1st of the next and been OK.

Also, like this month, if you were required to go every 4 weeks and you went on Dec 1,2, or 3 your 4th week would fall on Dec 29,30 or 31.  So then you would have 2 in one month and that wouldn't fly either!

What should have been a 6 mo thing for my DH turned into a year.  Not because of the diet thing, but because in each of the tests they ran they found something wrong and he'd need a further test.  But through all that he kept going to his PCP monthly just to be sure the ins didn't say he needed to start that over again.

Good luck.  You have to do it their way!  It's easier to say 'yes sir, I had no idea, sir, I'll be happy to start over, sir'.  Or is that the military?