Kuldeep Singh, MDPA
7625 Maple Lawn Blvd.
Suite 145
Fulton, MD 20759.
Ph: 301-490-2193, FAX: 301-490-3782
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COMPANY
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6 MONTH DIET
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NUTRITION EVALUATION
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PSCYH.
EVALUATION
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5 YEAR WT. HISTORY
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CARDIAC CLEARANCE
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PULMONARY CLEARANCE
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EGD /UPPER GI
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CAREFIRST
BCBS
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X
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X
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|
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|
|
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BC
FEDERAL
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|
|
|
|
|
|
|
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ONE NET
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X
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X
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X
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X
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X
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X
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X
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|
MEDICARE
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X
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X
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X
|
|
|
|
|
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CIGNA
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X
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X
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X
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COVENTRY
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X
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X
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X
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X
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X
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X
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X
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MAMSI/UHC
|
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X
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X
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MAMSI
FEDERAL
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X
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X
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X
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|
|
|
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ATENA
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X
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X
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X
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X
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UNITED HEALTHCARE
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?
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X
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X
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X
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|
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NCAS
|
X
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X
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X
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|
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These are our understanding of the requirements by the insurance companies. This document was last updated on the date below the document. These are guidelines and should be confirmed by calling your insurance company before the doctor’s office visit.
It is very helpful to have a note form primary care physician to send with the request for surgery.
*Medicare requires 6 month diet to be physician supervised. If the patient loses more than 10% of their body weight than Medicare will disapprove their surgery! Medicare patients must use “Center of Excellence” physician and hospital. Please note that with Medicare BMI itself is not an indication for the surgery. Patients need to have comorbidities i.e. diseases such as Diabetes, Hypertension, Dyslipidemia etc.
Most companies allow the diet to be broken into two separate diets of three months in length. Commercially available supervised diets are usually acceptable, but we may ask Primary care to co sign the weight sheets.
A summary letter from Primary Care is not accepted by the Insurance companies for the documentation of weight loss-they require actual office notes.
As Center of Excellence for MAMSI and United Healthcare, we may not need to send diet documentation for the patients within the local plans.
Out of State plans vary in both coverage and requirements. Patients are asked to call their insurance companies and be familiar with requirements and coverage.