I agree that it is a shame that the Duke Durham 'program' as a whole gets such a black eye because of the administrative stuff. I'm hoping that this will get better because as you say they really do have a wonderful, robust program. 

I'd love to meet you too! Maybe I'll see you at an upcoming event in the future.

One of things I would check into is if they do or are likely to require a 6 month medically supervised weight loss attempt. If so, I'd get that started with your PCP asap so that it will be done. Normally those are acceptable within 12 to 18 months of submission for approval. If you do a medically supervised weight loss attempt, you'll want to make sure that your Dr. documents this very carefully so that you don't 'waste' any of those months. Medicare documentation guidelines tend to be among the stiffest, so if you meet theirs, you are likely to be okay which means that it needs to be a visit where the purpose of the visit is Medically Supervision of Weight Loss. The Dr. has to document all of your vitals: height, weight, BP, pulse, etc... The Dr. needs to document the plan/results of your nutritional/dietary regimen, i.e., Atkins Diet, South Beach Diet, Low Carb Diet... The Dr. needs to document the plan/results of your exercise regimen, i.e., walking 20 minutes a day and going to the gym 3 times a week for resistance training or aqua aerobics 3 times a week, etc... The Dr. needs to document the behavior modification portion of your plan: i.e., counseling 2 times a month, or weigh****chers program, or ...

Best of luck and thanks for sharing this good news!