We will help bill your medical insurance! Many of our patients have received partial reimbursement for our program costs. Occasionally, all the costs are covered.

Insurance companies vary considerably in terms of the services they cover and the amount of reimbursement they provide for covered service. Because of the complexity and expense related to insurance reimbursement, we do not accept any insurance reimbursement at our clinics. We will, however, supply you with all the necessary documentation to file claims with your insurance provider, flexible spending accounts (FSAs) or health finance accounts (HFAs) administrator and your tax preparer.

Download Sample Insurance Letters

For your convenience, we've included a sample letter that you can personalize and send to your insurance company.

• Requesting Authorization of Coverage

If you are denied coverage, use the following sample letter to help you appeal denial of coverage for medical weight loss treatment from your insurance company.

• Insurance Appeal Letter

Your Plan - Insurance coverage for medical weight loss will depend on what kind of insurance policy your employer has negotiated with the insurance carrier. Many employees have alternative plans to choose from, so it may also depend on what plan you have chosen. Other factors that may influence your ability to receive reimbursement include:

• whether or not you have another health problem related to your weight (ie. diabetes, sleep apnea, hypertension, high cholesterol, etc.)
• what kinds of services you are receiving, and how many. For example, you may have full or partial coverage for the medical portion of the program, but not for the meal replacements.

FSA/Flex Spending Accounts

Patients who have a Medical FSA may use their current year plan to pay for eligible weight loss expenses. The key to FSA claims is proper documentation from one of our physicians stating the diagnosis of obesity and its treatment program. We provide this.  For further information, call us or contact a tax advisor.

Step-By-Step Guide to Insurance and Weight Loss

We recommend that you contact your insurance company to find out if medical weight loss treatment is a covered benefit, which procedures they will approve, and if you are allowed to select the doctor you prefer. Use the checklist below to help you, and be sure to document below every number you call, every individual you speak with, and the time and date that you spoke with them. Bring this with you to your appointment.

Step 1. Call Your Insurance Company

Call the benefits coordinator at your human resource office and/or call the customer service line on your insurance card. State "I am inquiring about my policy benefits regarding the medical treatment of morbid obesity (ICD 9 code 278.01). Is weight management for morbid obesity a covered benefit?"

If they say yes, then ask them what CPT procedure codes they cover. Don't forget to document this. Finally, ask them to send you a copy of their policy on the treatment of morbid obesity.

Please note that we cannot call your insurance company on your behalf unless you are our patient. If you wish us to assist you with this, you must be our patient first.

You may use the list below to help you ask all the questions and to document the answers received.

1. Telephone number and extension called: _____________________
2. Is treatment for morbid obesity a covered benefit?  Yes  No
3. Which CPT codes are covered? ____________________
4. Do you have a policy on treatment for morbid obesity that I can obtain?
5. What information do you require before authorizing the treatment?
6. Ask whether you are required to see an in-plan provider or a contracted provider. This may make it more difficult for you be approved to see us, and you may need to consult an attorney. This is the most difficult problem for patients in HMOs.
7. Get the full name and direct extension of the person with whom you spoke.

Step 2. Make Your First Appointment with My Weight Doctor™

Please download and fill out our enrollment forms, including our medical history forms, and bring them with you to your first appointment.

• Click here to Download our Enrollment Forms

Step 3. Contact Your Primary Care Physician

The most efficient method of securing insurance coverage is have your primary care physician’s recommendation that you need to participate in a medically supervised weight loss program. Ask your doctor if they would be kind enough to detail your weight-related medical problems and to indicate that they feel that medical weight management is medically necessary. Request a copy of your chart, especially your EKG and blood work.

What we will do after your first appointment with us

After your second visit at a My Weight Doctor™ clinic, one of our physicians will document your weight related problems and give you a “Letter of Medical Necessity”.  You will submit this letter, along with copies of your billing statements, to your insurance provider.  If approved, your insurance will reimburse your by mailing a check directly back to you.

Learn more about:

• Tax Deductions and Weight Loss
  
• Our Weight Loss Guarantee

Click here to sign up now