Question:
Who can I go to for a supervised weight loss? It seems that the
insurance will not work with just a PCP letter and documented weights with office visits. The PA I went to long longer works at my PCP's office. And, she does not have detailed information in my chart. I started supervised visits with my PCP, but I don't know if this will be enough to get accepted. And, I would rather start the six months now than to find out I don't qualify and then start over. — Nancy S. (posted on May 15, 2004)
May 15, 2004
Insurance companies are notorious for changing the rules mid-stream to
avoid approving WLS. Call your ins company and ask them exactly what they
consider "medically supervised" then GET IT IN WRITING AND HAVE
YOUR PCP AND SURGEON PUT IT IN YOUR CHART, and keep a copy for your
records. If they try to deny you 6 months down the line you will need that
document to get approved. Hope this helps,
Diane N
WeightlossSurgery.ws
— DianeN
May 15, 2004
I have Aetna HMO. I started from scratch in Saptember 2003 and visited my
PCP monthly for documented weight loss attempts and he specifically wrote
1200 cal diet. Once February 2004 rolled around I was approved within a
week and had the surgery 3-12-2004 and am now half way to goal!
219-172-126.--Good luck, Adele
— Adele R.
May 18, 2004
You may want to call your surgeon's office and ask what pcp he worls
closely with. That pcp would be WLS friendly and accustomed to what you
need documented.
My surgeon's office has a weight reduction program for those who needed it.
You would be given a 6-12 month module(booklet) on nutrition, behavior
modification, etc. In addition to reading the required material and doing
the written exercises you would visit the program director (who was
licensed)every 30 days and he would document your weight, your food and
excercise logs, if you had been to any support group meetings, restrictions
in your diet, etc. You may also need to visit with a nutritionist once a
month and he/she would document your progress also.
Over the course of several months you will have "documentation"
of a supervised weight reduction program.
— ToriJ
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