Question about x months supervised weight loss program for insurance

I went back and forth to my doc once a month - they were so savvy they had me come in on Oct 31 last year so that would count for October! - got their diet, followed it, and they submitted it. That part was a doddle. Before that, my prior approval (that I nixed) I went to my GP with my food diary once a month for a weigh in. It was also easy; he signed and stamped the diary and I sent it off to the surgeon's office.

I had to do nine months of Doctor supervised weight loss program for my insurance to cover my surgery. I went in each month and discussed my food journal and exercise journal. I was also weighed and measurements of my neck and waist were documented. Pretty easy visits, even though I was their first patient with my particular insurance to have to do the weight loss program at my PCP. Even with that my insurance denied me on my first go around. My surgeon called the insurance and submitted my A1C and meds list and the denial was overturned within three days. 

I just wished the surgery center would contact me so I know what I need to do and get started.  Getting a bit frustrated with the waiting game.

I would go ahead and set up an appointment with your PCP. Explain to them what you are doing, and get started on the monthly visits. Generally they will know what is required, and that way you are already on your way to meeting that requirement. If your surgeon's office has specific paperwork that they want completed (mine does- it was on their website), you can always have your PCP fill those out at the next appointment and backdate them based on their notes. Just a thought.

I have BCBS as well, and they counted my weigh****chers as part of the program.  I had been doing it since December, and I went to two NUT visits, and they counted the rest as the WW.  I think it really depends on your individual plan.

Hi there,

I have BCBS of Michigan and I have 6 months required weight loss. I'm three months in (it has flow by) and like civialmoma said its basically see the Doctor, Nut & Psych on a monthly basis and discussing nutrition and your health. I'm going thru the weight loss center at the local hospital and they are very good at knowing insurance requirements and making sure I get all my requirements in my six months. Good Luck.

Thanks so much for all the replies I've received.  You all have been very helpful for me to get this resolved.

I did contact BCBS again discussing some of the things I've read from this thread and I was told that I can meet this requirement by going through my PCP and documenting discussions about nutrition and exercise as well as keeping up with weight losses/gains.  I saw the PCP on on 6/20 and made an appt for 7/21.  This will put me one month in.

The following might help in the future for other's (just a little helpful advise here):

I had talked with BCBS on another matter prior and asked what happens if the information they provide is incorrect and is not accepted when submitted.  I was told by BCBS specialist that as long as you can provide operator's name, employee number, and call reference, they can retrieve the information on tapes and will abide by what you were told.  So always ask for employee's name, employee #, and call reference number any time you ask a question and are given an answer.  I always repeat the information I was just told before I end the call so that I am giving my interpretation of what I was just told and as long as they say, "That is correct," you have it on recording what you believe to be true.

I have BCBS of NC and I had to do the whole 6 months things also..... Its hard and sometimes I didn't want to go for my weigh in but I survived it and my last month was last Friday. I go see the surgen on 8/8/14 and I am so ready. Just remember you are doing this to make your self better, don't give up and six months will go by fast. Good Luck