What should Physician record every month?

[Bethanyblondie 0]

I am in month three of my six month diet plan. I am following Weight Watchers since it is an approved diet through Cigna. But I know a lot of people get turned down still by insurance because their physicians didn't "document" enough information every month. Mine asks me about my weight loss, exercise, and sometimes just if I have any other issues (like reflux, depression, etc). Is that enough information? Anyone have a specific template they had to follow?

[TQUAD64 9]

I have Blue Shield of California. They required a 6-month supervised diet. Either supervised by a nutritionist or doctor. I always went to the nutritionist, because it was free...no-co-pay and they were up on Saturdays. I had to go at least once a month.

Anyway, she always gave me a copy of her template sheet, which documented my progress. The sheet included date, weight, the topic of discussion she gave provided, and my exercise.

She also documented in struggles I had. Sometime my back spasms or catching the cold/flu would cause me to cut back on exercising. This was all documented.

We always talked about nutrition and this was documented on her form.

I hope this information helps.

[Bethanyblondie 0]

That info does help...thank you. Seems like we are pretty much documenting the same thing. I worry about having to fight for approval since I really don't have a two year history of co-morbidities, but my BMI has been pretty much over 40 the last six years, so I'm hoping that will be good enough!

[tashanicole1271 0]

My doctor's template also gave calorie recommendations and what type of diet was being followed, such as low fat, low, cal, etc.

[Band_Groupie 3]

I created my own combining the info./templates of the 3 hospital seminars I attended, and had it approved by the insurance expert at my surgeon's office (below- I condensed the lines/format). I was told insurance wants to see monthly goals for both weight (I was told not to gain, but not to lose much either, I'm on a step down calorie program) and exercise every month (as important as the weight), the Dr. visits must not be about anything other than this (that's how they code the visit for insurance-so don't combine it with a sick visit-someone on LBT was denied for it being a sick visit just one month.), and they also want to see some form of education is going on. I told my PCP I could initiate the topics (ie. last month I took in a family history list of all the obesity related issues in my family history-actually an eye-opener for me when I put it all down), we spent some time discussing it and my PCP educated me about them and she made notes in the Education section (this month I've prepared questions for my surgeon consult which is coming up). I attached my list to that month's visit. I fill out my self-assesment of how I did on last month's goals, the Dr. fills out the rest. Hopefully this will do it! Good luck!

DIET & EXERCISE PLAN FOR PATIENT: ________________________________DOB______________

Visit #: __________ Date: ______________

Current Weight lbs.: __________

- GOALS ACHIEVED FROM _____/_____/_____ :

- Patient Self Assessment:

• Nutrition: __________________________________
  

• Exercise: ___________________________________
  

• Sleep: _____________________________________
  

• Accountability: ______________________________
  

- GOALS FOR NEXT MONTH:

• Nutrition:
  
  • Pt. to Follow ____________ Calorie Diet
    
  • Fluid: No Caffeine, No Carbonation, No Calories, Between meals only
    
  • Quality: Emphasize Protein, Low Sugar, Low Fat
    
  • Regularity: 3 meals per day, Eat every 4-5 Hours, No grazing, Slow meal down to 20-30 min.
    

  [*]Exercise:

  • Pt. to Exercise at least ______________ Min. per Week
    

  [*]sleep

  [*]

  • Pt. to Achieve 7-9 Hours per Night
    

  [*]Accountability:

  • Keep Food/Activity/Sleep Log
    
  • Support
    
  • Education
    
  • Stress Reduction
    

- COMMENTS ON PATIENT’S PROGRESS:

_____________________________________________

- OBESITY HEALTH EDUCATION/GOALS-Post surgery, behavior changes, history, comorbidities, etc.:___________________________________________

MD Signature

_______________________________________________

[Bethanyblondie 0]

Thank you for the thorough information! I'm sure that makes getting insurance approval easier when you put in all that work and dedication. I definitely think I'll show that sheet to my PCP. I know I've gained a few pounds from all the Holiday food lying around...but overall I'm still down a few pounds since I started my 6 month diet plan. Thanks for your help everyone!