Question:
6-month monitored diet
Can an insurance company tell me that I did the 6-month monitored diet wrong if my primary physician is that one who gave it to me? My doctor also prescribed diet pills as well. Someone mentioned being denied because their doctor treated them for other stuff. — [Deactivated Member] (posted on February 24, 2009)
February 24, 2009
Tee, from my understanding, I was told by my insurance company the doctors
have the guidelines required by the insurance company, and if you follow it
to the letter, approval was a sure thing. I am doing a supervised diet
program now. The staff assures me that after my three months, as longs as
I still have insurance coverage, I want have any problems. They deal with
thousands of patients a year and are well aware of the requirements needed
for each insurance company.
— cocodrop7
February 24, 2009
I may have been that someone. My insurance required 12 months physician
supervised weight loss, but they wouldn't pay for the 12 months worth of
visits! My doctor soon tired of billing them, only to be denied payment.
A few times when I went in, I needed refills on my HRT medication, so he
was able to bill insurance based on my hormones. So....insurance had no
record of my seeing the doctor for 12 consecutive months for weight loss.
I was denied after I'd already gone through the phsyc. eval, several visits
to the surgeon, and a meeting with a nutritionist.
I called the insurance company to find all of this out, as my surgeon's
secretaries were of no help. I ended up asking my primary doctor to write
a letter stating that I had been seeing him for X amount of months for
weight loss, what my weight and BMI was and that he felt I would be a good
candidate for wls. I was approved for surgery the next day. Sometimes, I
guess, that's all they want is a letter from your doctor. Feel free to PM
me for other details.
— [Deactivated Member]
February 24, 2009
If you are put on a diet by your doctor your insurance company generally
accepts that you did what you were suppose to. The doctor ususally writes
his findings and they base it upon what he writes. They just want to know
you tried something else before going to this drastic of a step.
— trible
February 24, 2009
My Bariatrics Center gave me guidelines to give to my doctor that most
insurance companies followed. That way my GP was able to get in all the
information. Also I was told to make sure to make every appointment. If
you are one day late you have to start the six months all over again.
— janetkilpatrick
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