Horizon BCBS of New Jersey Revises Weight Loss Surgery Policy, Removes mandatory 6 Months

June 10, 2010 - PRLog -- The revised policy, which becomes effective on June 19, 2010, states the following:
The proposed policy, which is expected to be effective June 19, 2010, states the following:

D. Within the 12 months prior to the time of surgery, the member must meet all of the following requirements:  

1. Documentation of previous participation in conservative (non-surgical) weight loss program or diet program/plan (e.g., Weight Watcher, Jenny Craig). [INFORMATIONAL NOTE: Programs supervised by a registered dietitian may not be a covered service under a member's contract.]

The current policy, states the following:

D. Within the 12 months prior to the time of surgery, the member must meet all of the following requirements:
1. Documentation of successful completion of at least 6 consecutive months of supervised conservative weight loss program, diet programs/plans (e.g., Weight Watchers, Jenny Craig), or the Horizon Obesity Disease Management Program.

Successful completion means formal documentation or photocopies/print-outs of progress notes of at least monthly follow-up by the supervising physician, other health care provider, or program coordinator including the patient’s weight and progress relative to the goals set at the start of the program.
(NOTE: Pre-printed check-off forms and summary letters are NOT acceptable documentation for this requirement.)

[INFORMATIONAL NOTE: Programs supervised by a registered dietitian may not be a covered service under a member's contract.]


If you are a Horizon Blue Cross Blue Shield of New Jersey member and are currently on a medically supervised weight loss program, please contact us to review your insurance and potentially expedite the presurgical process. To learn more, please visit us online at http://www.njbariatricsurgeons.com.

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Drs. Abkin, Bertha, and Iannace of Advanced Laparoscopic Surgeons of Morris, lead a practice dedicated to minimally invasive weight loss surgery specializing in Realize Band, Lap Band, Gastric Bypass and Bariatric Surgery