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Need Some Advice Please Help!!!!!



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Does insurance companies approve weight watchers for the 6 month weight loss program that is required? I was denied on yesterday because they stated the weight loss physician does not have enough information about my progress and he only summarized my progress.I tried to get my physician to understand that they need progress sheets each time I made a visit,but he insisted his way was the right way really just brushing me off.Not to mention,the bariatric office I attend forgot to send my psych evaluation. I started over seeing this WLS physician and have been going the last three months,because I felt like his summary and yearly documentation wasn't going to work.My problem now is I can go three more months and have 6 consecutive month with the same ole sorry documentation and may still be denied,or I can start weight watchers on Tuesday for six months so I can have accurate documentation and get approved. PLEASE HELP

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I just copied my weight tracker from Weight Watchers and it was never questioned.

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I was told Weight Watchrs was not ok for my insurance.

I had to see a MD for 6 months.

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My insurance required a 6 month medically supervised diet, and only a physician is able to submit the letter of medical necessity for the surgery approval.

Weight Watchers, while an excellent program, does not provide the medical oversight necessary for many insurance companies to approve the surgery. Using the accurate documentation from Weight Watchers should be a good source of information to augment the information submitted by your physician. Perhaps both sets of documentation can be submitted together...just a thought!

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Make sure you include the WW but also ask your surgeons office if they have any forms that could be sent to your pcp to fill out about each of your visits. This same thing happened to me. I feel the WW helped, I also wrote a personal letter and copied pictures from an overweight child to the present.

The form my surgeon sent to the PCP had the following:

Visit date

Month ___ of 6

Name

DOB

Weight

Height

BP, pulse, temp, glucose if diabetic

Weight loss meds tried in past

Weight loss meds not appropriate due to

Obesity related co-mobidities

Current medications

Diet education discussed

Exercise/activity discussed

Behavior modification goals set with patient

Return visit scheduled for

Signature , date

My PCP filled this out after my 6 months because the insurance company called my surgeon and said if they didn't get better PCP documentation they would deny it, took 24 hours to get this paper work back to them and 2 hours later I got my approval

Good Luck! It will happen!

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Forgot up at top with WL meds is the number and type of weight loss programs tried on your own.. Ie, WW, Jenny Craig, slim fast etc....

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