Question about 6 mo dr. visits for weigh in

[daco525 0]

My ins. Horizon BCBS of NJ is requiring 6 consecutive months of doctor visits where diet is being monitored medically. Here is the question. I have 9 months of weight watchers. I sent my 9 months of weight watcher weigh in documents to my doctor. He wrote up a letter document the consecutive weigh ins. We also wrote up monthly notes about diet, exercise, behavioral changes which they also want. Do you think the insurance will accept this or will I be denied since I did not actually go to my doctors for 6 appts. Will they be able to tell this? I do go every 3 months for treatment of co-morbid conditions. If this is grounds for denial I am thinking I should start this month making an appt. By the time I submit everything to insurance in Jan., if they deny it by Feb. I will at least have 3 months of the visits completed. Any info or experience with this would be helpful.

[ebonie1015 0]

Hi-

I have BCBS of Alabama and I know that if you use your Weight Watchers as documentation for the 6-month diet, you must have seen your physician twice in that six-month period and he/she must have it documented in your medical records that you are being counseled in regards to your weight loss attempt. It can't be regular office visit notes. The visit must pertain only to the weight loss monitoring.

I had done WW but because I only saw my doc once in that period and the one visit wasn't pertaining to my weight loss attempt, they denied.

I did do the six-month physician supervised diet and I had one visit per month that pertained only to my weight loss and made sure that the diagnosis for each visit was morbid obesity. That way there were no questions as to why I was seeing the doc. I was approved without question.

Hope I was somewhat helpful.:thumbup: