ChunkyCali 51 Posted January 17, 2021 Hello, Looking for others that have Anthem Blue Cross PPO in California. At my initial visit with the surgeons office they instructed me to have 6 months of dietician visits. Anthem had sent me links to their policy document cg-surg-83 that (to my reading!) looked like 6 months wasn't required as of August 2020. The policy states: Documentation of all of the following: Past participation in a weight loss program; and Inadequate weight loss despite a committed attempt at conservative medical therapy (for example, comprehensive lifestyle interventions, including a combination of diet, exercise, and behavioral modifications); and Also: Revised 08/13/2020 Medical Policy & Technology Assessment Committee (MPTAC) review. Revised criteria requiring participation of at least 6 months in a weight reduction program. Revised not medically necessary indications to remove examples of devices which are no longer available. Updated Discussion and References sections. Reformatted Coding section. I have all of my clearances except for another 2 months of dietician visits. What I'd like to do is ask my surgeons office to just submit to insurance now with the hopes that I will get surgery end of Feb/early March. Has anyone got any recent experience I can draw on to help inform my decision and make my case! Share this post Link to post Share on other sites
mattk53 124 Posted January 17, 2021 I also have Blue cross PPO and they only required three months where I filled out: How I was exercising, What I ate and how much weight I lost. Then I had to have my doctor sign it. Of course that's on top about 10 different test. 1 ChunkyCali reacted to this Share this post Link to post Share on other sites