Insurance - 6 months or 6 visits?

[Kelly1121 26]

My insurance says I need to be in a medically supervised weight loss program for "six months" and the bariatric center I'm working with says that when they called about insurance requirements they stated "six visits". I'm going to call insurance on Monday and verify once again, but I'm curious, if you've gone through a required # of visits, did they count it as visits within a month?

For instance (my first visit was 11/15/15) - six months to me means:

11/15-12/15: month 1

12/15-1/15: month 2

1/15-2/15: month 3

2/15-3/15: month 4

3/15-4/15: month 5

4/15-5/15: month 6 - making me ready to submit to insurance around the end of May.

OR - was it viewed as this?

11/15 - month 1/visit 1

12/15 - month 2/visit 2

1/15 - month 3/visit 3

2/15 - month 4/visit 4

3/15 - month 5/visit 5

4/15-month 6/visit 6 - making me ready to submit to insurance around late April.

If it's the second, I'm a month closer to surgery than I was originally planning, which would be incredible! Like I said, I will call insurance on Monday when the bariatric center is open to confirm, but I'm curious now. I have United HC.

[katanne 215]

My surgeon requires three (or six if that's someone's insurance requirement) visits one month apart. The day of my initial consultation, which included a weigh-in and meeting with the dietitian, counted as the first visit.

[wildwolf235 2]

My insurance also required 6 months. My dietitian said my 1st visit was considered the 1st month, then I went back one month each until I had reached 6 visits. So technically I had only done 5 months and got approved.

[nicksmommy 139]

My insurance co requires the first scenario you gave (with the May date).

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[shrinkingkimber 200]

Mine just requires 6 different months. My last visit will actually be on June 1 so that they can submit to insurance that day to try to get me in for surgery before my insurance year restarts in July! Luckily they said my insurance is just a call and they find out during the call if I'm approved or denied.

Edited March 12, 2016 by shrinkingkimber

[missvee 28]

My insurance company requires 6 months of supervised visits. My first appt with the surgeon was 2/10 and he gave me a tentative surgery month of August if all goes well I've done all testing all I have left is my psych eval on Monday. Time really does fly by!

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[Kellanrevere 1]

I recently received a denial letter from my insurance based on this exact subject. My insurance required "3 months" of visits. I did 3 visits about month apart, paperwork was submitted by the doctors office and we thought we were good to go. Then came the denial letter that said I hadn't met the 89+ days of following my dietician. What The Heck ?

This is from Cigna insurance, not a fly by night. I would call your insurance just in case.

If Cigna had made it clear they would have saved themselves money as I would have scheduled my appointments differently. It would have also saved my doctors staff time and saved me anxiety when I received the denial. Doctors rushed me in for appointments and we got approval within 2 weeks. Surgery scheduled for March 29 !

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[lovemylukers 80]

I have blue Cross Blue Shield and the required 6 months of visits however my doctor told me that it was just 6 visits so I did my 6 visits and we submitted that to insurance and I was approved 2 days later. I would call your insurance company and ask them.

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[applejenn 173]

I believe it's one visit a month. At least mine was. I have BCBS Excellus and I was only required 4 NUT visits, 1 visit each month, psych evaluation

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[Kelly1121 26]

Yay! Found out it really was just six visits. Submitting to insurance tomorrow!

Edited April 26, 2016 by Kelly1121

[Seagull 140]

I just had this happen to me:

First visit ended up counting as a consult and I had to do a 7th month. GHI

[skinny_knees 55]

I have to do 6 months which is 7 visits and I have to have at least 180 days between visit 1 and 7.

Edited May 12, 2016 by skinny_knees

[secresc 4]

I have UHC insurance, 6 visits 30 days apart. I had surgery 6 wks after my 6th visit. Ask the question in network or out of network. Out of pocket cost is much more.

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[leahhindi 65]

My insurance stated months but my surgeons office assured me that they meant three months worth of visits so I was able to do it more quickly. Worked out well. Was sleeved on Monday.

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[TheStruggleIsReal 18]

United Healthcare PPO here.

My plan required 6 visits in different calendar months within the past 24 months.