BLKsAunt

I have Horizon BCBS. has anyone had to submitt notes from WW Documentation of successful completion of at least 6 consecutive months of supervised conservative weight loss program, diet programs/plans (e.g., Weight Watchers, Jenny Craig), or the Horizon Obesity Disease Management Program. Successful completion means formal documentation or photocopies/print-outs of progress notes of at least monthly follow-up by the supervising physician, other health care provider, or program coordinator including the patient’s weight and progress relative to the goals set at the start of the program. (NOTE: Pre-printed check-off forms and summary letters are NOT acceptable documentation for this requirement.)

Pls post your experiences here. I used to have a link to their Medical Policy...it's gone now. Looking for help...especially what is acceptable for "supervised conservative weight loss program for 6 months which may be provided by the patients's physcian, a PCP, or registered dietitian"

Hope this hasn't been suggested or already here... I'm looking for a file section w/ examples of Medical Necessity letters. Would hate for my MD to add the wrong thing to a letter.