Medically supervised, three component, weight loss program
Can anyone help....I found my insurance providers requirements online and one of the requirements states:
Individual has participated in a medically supervised, three component, weight loss program of at least three consectuive months duration within the 18 months preceeding the precertification request.
It also states in the policy that you can do a 6 month weigh****chers program with 3 or more visits to your doctor during that time period.
I had heard previously that my insurance company requires 6 months....so I am really waiting to hear from my doctor's office to provide me with the exact requirements. If you can shed light on what the three-components are or what your experience has been with Med Mutual that would be GREAT.
Individual has participated in a medically supervised, three component, weight loss program of at least three consectuive months duration within the 18 months preceeding the precertification request.
It also states in the policy that you can do a 6 month weigh****chers program with 3 or more visits to your doctor during that time period.
I had heard previously that my insurance company requires 6 months....so I am really waiting to hear from my doctor's office to provide me with the exact requirements. If you can shed light on what the three-components are or what your experience has been with Med Mutual that would be GREAT.
I don't know about Med Mutual....
However the state of Maryland requires 6 months of medically supervised nutrition counseling for WLS within a certain time period prior to surgery...
This basically amounted to going to a nutritionist once a month for 6 months straight. I did this at my surgeon's office.
or
if you have 6 months of documented WW program stuff or a simular program you could use that.
Again, this is just my experience.
However the state of Maryland requires 6 months of medically supervised nutrition counseling for WLS within a certain time period prior to surgery...
This basically amounted to going to a nutritionist once a month for 6 months straight. I did this at my surgeon's office.
or
if you have 6 months of documented WW program stuff or a simular program you could use that.
Again, this is just my experience.
no, not really. My guess... recorded weight, recorded nutrition counseling, and uh maybe a recorded daily dietary log??? Those are the things that I basically had to do. I'm really not sure. However I'm sure your medical team has all the answers and will make sure you meet whatever qualifications your insurace requires.
they may have changed their requirements. My insurance company (Cigna) used to require 6 months but just changed their policy last month and now they require 3 months medically supervised weight loss program. I noticed that even my doctor's office has the outdated info posted on their website! (they have the requirements from all major carriers posted so prospective patients can check).
You may want to call your insurer to check -- I did and the benefits counselor was very helpful in explaining their recent change.
You may want to call your insurer to check -- I did and the benefits counselor was very helpful in explaining their recent change.
I have contacted my insurance....they are very very vague. My doctor said that they are vague when they talk to the patient and they give the exact information to the doctors office. I am just hoping know what is expected so I can get appointments set up. What I'm really hoping to figure out is what the three components are.
"three components" usually refers to diet, exercise, and behavior/lifestyle modification. I don't know exactly what the third component refers to beyond diet and exercise though! I would bet your doctor's office will know what is expected though. They make a living by knowing how to cross their T's and dot their I's with insurance companies!
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