Documented Weight Loss

[chimboree26 24]

Just curious...if your insurance company required 6 months documented weight loss efforts, what did you provide and did they accept it?

Was it Jenny Craig, Weight Watchers, gym receipts, journals/logs, etc???

Thanks!

[anonemouse 1]

I did one before I even heard about the lap-band. A NP from my gynecologist's office runs a Phentermine program, so I signed up for it. I was on it for an entire year. Even though I didn't lose much weight with it, I am glad I did it, just because I was able to use it as my documented weight loss effort when I decided to have surgery.

I would think that the insurance would accept anything, as long as it was documented by your doctor. That's the kicker, in most cases. I have heard of people being denied because they weren't weighed at their doctor's offices every month (and the weight being the reason for the appointment). Make sure that you know whether your insurance just requires documentation of your effort or whether they want documentation of a medically-supervised weight loss attempt.

[faithmd 14]

Laurend is right on with describing my insurance company. I had to be on an MD supervised program and weigh in every month, and we had to discuss my weight at each visit. I couldn't miss a single month, not one, or the year would start over.

But every single insurance company is different. the key is that you MUST call your insurance company and ask what their SPECIFIC requirement is. Then ask them to send it to you so you have it in writing. I know some insurances do allow things like documentation from Jenny Craig, etc.

[chimboree26 24]

Make sure that you know whether your insurance just requires documentation of your effort or whether they want documentation of a medically-supervised weight loss attempt.

Well, I am going to do like ya'll suggest and get my insurance co. to send me the exact requirements. The docs office told me the insurance requires at least a 6 mos weight loss history - not a medically-supervised wt loss. I am just starting to get nervous :nervous thinking my Curves documentation won't be enough...

Please pray for me!!! I don't want them to come back and deny me.

[Big As Life 0]

My daughter has to do this, and they just wanted documentation from any source that shows her weight...everytime she went to the doctor, they weighed her, so that is documentation....

[Wheetsin 714]

You'll probably not find an insurance company that would accept Weight Watchers as a supervised diet. And that applies to any subscription type programs, and would definitely not include a gym membership.

99% of the time they're wanting a medically supervised diet, which means you going to the doctor's office with the specific intention of getting weighed and receiving feedback on your progress. Even if you go for other things, and get weighed, it's not a part of a medically supervised diet. Your visits have to be specifically coded under a weightloss listing (probably morbid obesity).

I see that you were approved yesterday, the same day you posted this. Pure curiosity, or are you anticipating your insurance company will change something?

[chimboree26 24]

My daughter has to do this, and they just wanted documentation from any source that shows her weight...everytime she went to the doctor, they weighed her, so that is documentation....

Was this documentation sufficient? Were her visits specifically for wt loss or was she seen for other stuff? And can I ask, what insurance does she have?

Thanks!

[chimboree26 24]

You'll probably not find an insurance company that would accept Weight Watchers as a supervised diet. And that applies to any subscription type programs, and would definitely not include a gym membership.

99% of the time they're wanting a medically supervised diet, which means you going to the doctor's office with the specific intention of getting weighed and receiving feedback on your progress. Even if you go for other things, and get weighed, it's not a part of a medically supervised diet. Your visits have to be specifically coded under a weightloss listing (probably morbid obesity).

I see that you were approved yesterday, the same day you posted this. Pure curiosity, or are you anticipating your insurance company will change something?

Well, I'm thinking I jumped the gun...I got the call from the doctor's office and they told me that I have the coverage and I just need to send them my psych eval and 6 months of weight loss history...I'm just nervous about the wt loss history part. I haven't been on a medically supervised diet. I printed the actual medical policy and it says that the "structured diet program can include commonly available diet programs such as Weight Watchers or Jenny Craig..." I've also requested my insurance co to fax me a copy of the exact requirements.

[Melissa S 1]

I was just approved today by Empire BCBS of DE...who requires a medically supervised diet.... this is what was sent:

*Emails to and from my PCP discussing losing weight, going to the gym and changing my diet, requesting lab work as well as lowering my BP

*Gym billing records from 8/05 to present

*Letter from my PCP confirming all of my weight loss attempts and my intentions discussed in the emails

....I'm sure my surgeon's office also sent them my records with the sheet where they ask you to fill out diets tried, weight loss meds taken, programs attended...and the amount of time you spent on each as well as how much weight lost on each... I did go to my PCP about once a month for different ailments and issues...but never specifically for a weigh in or to discuss my weight. But it was documented that my BP improved drastically... ****

I'm sure it varies as to what insurance uses for proof of the 6 month medically supervised diet...

****About 95% of the time when I went to see my primary for random issues... I was not weighed....

[shell850 0]

I had to go to the DR. every mon. for six mon. before I could even submit anything to the Ins. comp. but each ins. is dif. call them and ask they told me everything I needed to get started. Good Luck