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Weight Loss Program documentation?

I have Anthem Blue Cross of CA and based on what they've told me over the phone and the medical policy they directed me to, I have to show documented attempt at non surgical weight loss for 6 months within the last two years.

So Anthem told me it could be WW receipts, or invoices for the medical weight loss program I used.

But the surgeons office Told me that invoices aren't good enough, and that they need to see that I was counseled on nutrition, the actual numbers of pounds lost, etc.

Does anyone know what passes as valid documentation for Anthem?

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I like your passion and commitment. I would be sure to convey that to the surgeon, NUT, and psychologist when you meet. Once they've seen that side of you, share your frustration, plan to go to Mexico and ask if they can help.

I basically told my team that I could only go with them if they could fast track me and they did.

If I hadn't asked and shown them my conviction, I'm sure it would been a 6 month process

  • Author

I like your passion and commitment. I would be sure to convey that to the surgeon, NUT, and psychologist when you meet. Once they've seen that side of you, share your frustration, plan to go to Mexico and ask if they can help.

I basically told my team that I could only go with them if they could fast track me and they did.

If I hadn't asked and shown them my conviction, I'm sure it would been a 6 month process

Well that worked! I brought my weight loss program docs in hand when I went to my consultation, told them that I had been looking into this for quite some time and had even allowed myself to get talked out of it in 2012, and I've even considered going to Mexico if insurance gives me a hard time. They told me that I would definitely have to do a some nutritional counseling with the program and do all the medical clearances (perfectly fine), but how many sessions is determined by the surgeon. The surgeon came in and asked me what surgery I was looking into, I told him VSG, he looked at my documentation and said that he thought two nutritional sessions would be fine for me.

So they're going to submit for approval once I get the rest of the medical clearances, and he said that March/April should be a decent time to look forward to surgery if all goes as planned.

So they're getting all my appointments set up as soon as possible, and hopefully I will be on my way to a better life sooner rather than later! ????????????????

  • Author

Does your plan cover the nutritionist. My surgeons office said my insurance won't cover the nutrition part. Seems weird and adds 540 to my bill.

No, it doesn't. However they're prorating the amount since the surgeon only requires me to take two classes instead of 6.

  • 4 months later...

Thank you all for sharing, before seeing this post. I started writing a letter that chronicles all my diet efforts from middle school to date. I will show proof of recent efforts such as hcg, atkins, meal delivery, medifast, weight watchers, quick weightloss, LA weightloss & much more, including wellness initiatives at work.

Sent from my LGMS631 using the BariatricPal App

  • 3 weeks later...

Chef, I also have UHC and it's required I have 6 months of consecutive weight loss programs within 2 years. They won't except 2 months here 3 months there. I have many attempts as well. I wonder if I should talk to someone about this.

Sent from my iPhone using the BariatricPal App

Thank you all for sharing, before seeing this post. I started writing a letter that chronicles all my diet efforts from middle school to date. I will show proof of recent efforts such as hcg, atkins, meal delivery, medifast, weight watchers, quick weightloss, LA weightloss & much more, including wellness initiatives at work.

Sent from my LGMS631 using the BariatricPal App

Please let us know how this turns out. It seems that the approval process is a bit of a "black hole" for a lot of people starting out.

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