Weight Watchers Documentation

[TheMomHere 0]

Does any one know what bcbs of michigan requires from Weight Watchers as far as documentation they require from them to cover the 12 month supervized and documented diet? Thanks. Patti

[Wheetsin 714]

Definitely check with BCBS on this because I've never heard of an insurance company being willing to accept something like Weight Watchers or Jenny Craig as supervised weightloss. What they're usually requiring is medically supervised weightloss documentation, meaning you have been going to your doctor or other qualified medical professional specifically for treatment of obesity.

In other words, having gone to your doctor for whatever, and having your weight in your records isn't enough. They're looking for a diagnosis or code that's specific to weightloss/obesity.

This doesn't mean it's impossible, but I personally have never heard of a carrier willing to take participation in a non-medical facility program as proof of the supervised attempt.

[wrestlersmom 0]

Here is a piece of the by laws for BCBS....READ the word OR below..Its what your looking for..

a friend,

Rose

At

least one attempt must occur during the one year prior to request for surgery or date

of surgery. Documentation must support participation in the program for six

consecutive months. The following criteria must be met for this participation:

▪ Documentation of participation in a physician supervised program of nutrition

and increased physical activity (including dietitian consultation, low calorie

diet, increased physical activity and behavioral modification). Documentation

of program participation must appear in the medical record by the attending

physician. Documentation should include comments by the physician

regarding patient progress or lack of progress. A letter does not meet this

requirement. There must be medical records to document medically

supervised weight loss attempts;

OR

Acceptable with medical record documentation of medical supervision are:

Weight Watchers, LA Weight Loss, Jenny Craig, EatRight etc. Not

acceptable are self-directed programs such as joining a gym, Atkins’ diet,

calorie counting, low fat, cutting back, internet programs, etc.

4.

[marnie723 0]

I looked up the fax from my BCBS Mich provider & they say," a 12 mth period of weight loss that can be WW or Jenny Craig etc but it must be documented by a medically supervised weigh- in with a physician"

I thiink you really need to find your employers specific outline of coverage. It seems every employer maybe different. Bottom line seems to be a pcp must sign off every month.

[CaresaRN 0]

I used my weight watchers for my Dr. supervised diet. I simply had my PCP write a letter stating that she recomends WW, langth of time on WW, weight loss and regain. Then I asked WW to e-mail me all of my on line daily food records and sent them all in. Was approved in a heart beat. United Health Care.

Caresa!

[footballmom104 0]

WW irritates the bejebbers out of me! I e-mailed them yesterday to try to get my lifetime membership number so I could get some records (I can't find my membership books) and they were like "We cannot provide these kinds of records for you, you will have to show your physician a cancelled check or your membership book" and gave me info on how to obtain a new lifetime membership number - in other words, how to rejoin. I always had trouble sticking to their plan because I simply cannot eat fruit and I was told that it was required. And the people who own the franchise here are soooo self-righteous they make me want to scream . I did much better on ediets, but I still gained all but 5 lbs of it back. That's still better than WW, where I always gained it all back and then some :faint:

[LauraD 2]

I am BCBS, and when I asked my surgeon's coordinator about this, she told me that in the past, they've had success photocopying the booklet where they paste your weekly stamp, and faxing that to the ins. co. But that is not my personal experience so don't take it as gospel!

Have you called a customer rep at BCBS and asked them? They've been very helpful with me on the phone, so far.