BCBSAL Precert Questions

brad35963
on 8/19/14 1:24 am - Fyffe, AL

Hello guys, I am new to this forum. I have a few questions.

My insurance, BCBSAL, says that I must undergo the 6 months of diets worded as follows:

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 no less than
monthly for a period of 6 consecutive months 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;

 

So in small terms, does that mean that I can visit my family physician once a month for 6 months for him to chart my progress and all that, or do I have to see a dietitian as well? Does my family physician also suffice in place of things such as weigh****chers or jenny craig, etc?

 

Any advice from anyone else with BCBSAL with getting certified to have surgery? I am 6'0 and weigh 347lbs. I have High Cholesterol, Hypertension, and Pre Diabetes. Hopefully it won't be too hard to get approval. 

(deactivated member)
on 12/2/15 9:04 am

Looking at the date, probably too late of a reply, but would appreciate feedback on your results.  I'm currently working through BCBS of Alabama.  My bariatric doctor gave me 7 forms to have my primary care physician fill out.  First appointment and six 1-month appointments.  Key to approval is making sure your physician codes your visits correctly as my previous visits were not recognized.  The forms provide a secondary paper trail and are sent from my physician to the bariatric doctor for my insurance application for surgery.

Robert P.
on 3/14/17 6:44 am - Pelham, AL

To cover all the bases, you'd do well to get your doc to enlist the help of a dietician or nutritionist. Another option is something like a Medical supervised program such as Medifast. I wouldn't suggest Jenny or WW, unless they have an actual physician there.

You clearly meet the co-morbidities, so the 6 months and the psychiatric screening should be all you need. BCBSAL was my insurance also.

High 468 / Surgery 433 / Current 243/ Goal 219
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