Insurance and the 6 month requirement

[SAD HATTER 122]

My pcp doctor's office has a service where we check in each month for a bp and weight check when we are dieting. So there is documentation of my monthly weight, but no visit notes. Does anyone know if tge weight documentation after the initial visit meets the requirements, or if they demand visit notes?

[BLERDgirl 6,417]

It varies depending on your insurance. Your best bet is to call the insurance company and ask them. Then you can let the doctor's office know.

[GreenEyes604 753]

Who is your insurance carrier?

[SAD HATTER 122]

I have united healthcare. I better do a full appointment just to cover my rear. I dont want them to have any reason to be a pain in the rear. My husbands work will basically stop paying part of my premium if i am still comsidered obese next year so i dont want to mess around.

[BLERDgirl 6,417]

Instead of guessing call or at least look up the policy online.

[Sharon1964 2,530]

My surgeon's office gave me a documentation checklist, since I wanted my pcp to do the monthly visits. My doctor had to document at every visit for six months weight, discussion of nutrition and eating habits, discussion of exercise, and a couple of other things. Just a weight check would not be enough.

I would definitely call your insurance and ask them directly.

Edited February 19, 2015 by Sharon1964

[SAD HATTER 122]

I called and they were very vague as to what documentation is required for tge 6 months. UHC doesn't have the info online for that portion of our policy. Just that it covers it over 40 bmi.

[BLERDgirl 6,417]

@@SAD HATTER - call them back and make them be specific. Explain that the program does monthly weight checks and ask if that would be sufficient or will they be requiring more detailed documentation. Make sure you get the full name of the person you speak to.

[efierke 60]

Talk with your surgeon - My *surgeon* required 1 class/month for 6 months, and that included weight/bp checks and turning in a food log. That filled the 6 month requirement for my insurance, and I felt a lot more prepared going into the surgery. I also believe that it is a requirement under the Bariatric Centers of Excellence program (if not required, it's definitely a good idea). The surgeon's office or hospital should also have an insurance coordinator for elective surgeries that can help you with the requirements.

[BLERDgirl 6,417]

@@efierke - It's not a requirement. I didn't have to do 6 mths and my hospital also has the Bariatric Centers of Excellence designation. In fact I didn't have to do pre-op diet of any sort.

[mclorrie 219]

Sad Hatter - I have United Healthcare too.

I'm meeting each month with the dietician, and other members of my bariatric team. I thought it was going long and drawn out, but was pleasantly surprised when I met with my dietician for the first time last month. They counted my appointment with my surgeon as the first visit. So I completed two of those appointments in January!

I would recommend you do complete appointments - they'll weigh you at the very beginning, and you learn a lot from speaking to each of the staff! My third appointment is next week - and I'm excited to be halfway done! I'm really surprised how fast all of this is going!

As a requirement with UHC I also had to set up appointments with a bariatric case nurse from Optum. I'm not sure if that's something they require of you, but I've spoken to her once, and she's offered lots of good information. My next appt. with her is in May.

I hope this is helpful!

[SAD HATTER 122]

I am doing my 6 month diet appointments with my primary care physician. The Dr is over 2 hours from me and I cannot take off that much each month. So I am having my pcp forward everything to the bariatric center. Did you use Optum too?

[mclorrie 219]

I am doing my 6 month diet appointments with my primary care physician. The Dr is over 2 hours from me and I cannot take off that much each month. So I am having my pcp forward everything to the bariatric center. Did you use Optum too?

That's totally understandable! I'd do the same thing if I were in your shoes!

I live 35 miles south of where I work, so I commute everyday using a vanpool called Rideshare. My WLC is a few miles west of where I work so on days I have an appt. I drive myself to work and go to my appt.

I joined Optum, because that was a requirement under my UHC coverage for bariatric surgery. My healthcare is covered by my employer, so that's probably why I had to join.