"Consecutive" Question

[LittleLou 31]

My insurance requires 3 consecutive months (<90 days) of nutritional evaluations, so here is my question.

My first appt was 8/15, my next isn't scheduled until 9/27 and the next is 10/25. Clearly, the months are consecutive - August, Sept, October, but the difference between my first and second month is over 30 days.

The time between my first visit and last is under 90 days, but i'm concerned about the timeframe between my first and second. I've asked my surgeon's office and insurance coordinator, who said it is fine, but I can't help but be concerned that insurance is going to decline because of it.

Anyone know what they really mean when they say consecutive?

[JerseyGirl68 1,172]

I would check with the coordinator at your surgeon's office, or call your insurance directly to be sure, all insurance companies have different rules. But your coordinator should be well versed in what your requirements are.

Best of luck!

[ashelaine 383]

It actually works out to be 4 visits. You would have August 15, sept ___ (30 days), oct (60days) November (90 days)

[LittleLou 31]

It actually works out to be 4 visits. You would have August 15, sept ___ (30 days), oct (60days) November (90 days)

That is what I thought too, but it requires 3 consecutive month visits, and August 15 counted as month #1. I questioned it, but this office has been around for a longggg time and they deal with my insurance company, and obviously this type of stuff, much more than I do so I went with it.

[ashelaine 383]

That is what I thought too' date=' but it requires 3 consecutive month visits, and August 15 counted as month #1. I questioned it, but this office has been around for a longggg time and they deal with my insurance company, and obviously this type of stuff, much more than I do so I went with it.[/quote']

Does it state 90 days in your plan or 3 consecutive months? Mine stated at least 3 months (90 days) that's an exact quote from the website- aetna in my case. I worked in insurance for a while- so while I'm not a surgeon or a coordinator I did do claims for a while. I would read what your provider requires specifically because there are tons of stories where people blindly trusted in office coordinators and were told false information- all I'm saying is know exactly what your insurance requires before you are submitted and denied for a silly reason

[Macy6 356]

My coordinator had me schedule between 3-4 weeks apart. So my first appt was late Jan and I went every 3-4 weeks after with my final appt being June 17th. I needed 6 months and my first appt counted as month 1.

[LittleLou 31]

It says (in exact words) 3 consecutive months (Less than < 90 days) and my coordinator told me that I had to be seen once each month - so if my appt was Sept 30th and I cancelled it, even if my re-scheduled appt was within 30 days of my last appt, if I wasn't seen IN September, I'd have to start over.

[JP0P 9]

Wow, that's so weird. So a person would be best suited to have one on Aug 30, Sep __, and Oct 1. That doesn't seem fair. My surgeon required a 12 week behavioral program that met once per week. My insurance required 6 months of a monitored diet. Monitored meant having a checkup at and then one 6 months later.

WLS is a huge mess of different things for different people. Good luck!

[LittleLou 31]

Well, I have had to do SOOOO many other things besides those appointments. I can't WAIT until it's all over.

[Pookeyism 1,143]

I don't think you will be any worse off for a fourth visit, and if it concerns you schedule them closer, and throw in a fifth (lol)...these meetings are not just a 'git er done' - or if they come off like they are go somewhere else. Take these visits to learn and ask questions.

[LittleLou 31]

I don't think you will be any worse off for a fourth visit, and if it concerns you schedule them closer, and throw in a fifth (lol)...these meetings are not just a 'git er done' - or if they come off like they are go somewhere else. Take these visits to learn and ask questions.

I think I will benefit a lot more from those meetings AFTER the surgery. Right now I am "maintaining" because if I lose weight I will go under the 35 BMI. I've learned more from these forums and my support group meetings than the nutritional meetings. But again, I know I will lean on them heavily later down the road.