Weight Loss

Policy for Medically Supervised Weight Loss Program Utilizing GLP-1 Agonists and Other Weight Loss Medications

Introduction

This policy outlines the requirements for participation in our medically supervised weight loss program, which incorporates the use of GLP-1 agonists and other weight loss medications. This program is designed to provide comprehensive care and optimize patient outcomes through regular monitoring, medication adjustments, and lifestyle counseling.

Program Goals

The primary goal of this program is to help patients achieve and maintain significant weight loss in a safe and effective manner. We aim to provide evidence-based care aligned with clinical studies demonstrating the efficacy of GLP-1 agonists and other weight loss medications in conjunction with lifestyle modifications.

Program Requirements

1. Monthly Visits: Patients are required to participate in monthly follow-up visits, either via telemedicine or in-office. These visits are crucial for monitoring progress, assessing medication efficacy and side effects, and making necessary adjustments to the treatment plan.

2. Prescription Management: Prescriptions for GLP-1 agonists and other weight loss medications will typically be provided on a monthly basis, unless insurance mandates a 3-month supply. Regardless of prescription frequency, monthly follow-up visits are mandatory to ensure appropriate monitoring and medication management.

3. Commitment to Goals: Patients must be committed to actively participating in the program and adhering to the prescribed treatment plan, including medication adherence, dietary modifications, and physical activity recommendations.

4. Monitoring and Support: We provide ongoing monitoring of weight, body composition, vital signs, and laboratory values to track progress and ensure patient safety. Lifestyle counseling and support are also integral components of the program, empowering patients to adopt healthy habits for long-term weight management.

Program Fees

• Insurance Coverage: If your insurance covers your visits, you will be responsible for your copayments, deductible, and/or coinsurance as applicable. Copays when applicable are due prior to visit. Under no circumstances copays or deductibles would be waived.

• Self-Pay Patients: Self-pay options may be available. Please inquire with our team to obtain the self-pay policy and fee schedule when applicable..

• No Show/Same day Cancellation or rescheduling: $45 No Show fees will be charged if you failed to cancel or reschedule at least 24 hrs prior to scheduled visit. Some exceptions may apply at the office discretion No-Show fees may be waived in certain circumstances. 

Medication Coverage

• Our physician and care team will thoroughly investigate your insurance coverage for weight loss medications and strive to ensure you receive the best available treatment options within your plan.

• For patients without insurance coverage for weight loss medications, our physician will recommend the most appropriate and cost-effective treatment options for your specific needs.

Prior Authorization

• Most health insurance plans require prior authorization for weight loss medications. This can be a complex process that necessitates commitment to maintaining qualifications for continued coverage. Our program is designed to provide the necessary support and documentation to help you meet these requirements and sustain coverage for your treatment.

Best Outcomes

Clinical studies have demonstrated that medically supervised weight loss programs utilizing GLP-1 agonists and other weight loss medications can lead to significant and sustainable weight loss, improved metabolic health, and reduced risk of obesity-related complications. However, achieving these outcomes requires active patient engagement and adherence to the program requirements.

Policy Rationale

This policy is designed to ensure that patients receive the optimal level of care and support necessary to achieve their weight loss goals safely and effectively. Regular monitoring and medication adjustments are essential to maximize efficacy and minimize potential side effects. By committing to the program requirements, patients demonstrate their dedication to achieving sustainable weight loss and improving their overall health.

Conclusion

If you are considering participating in our medically supervised weight loss program, we encourage you to carefully review this policy and discuss any questions or concerns with our healthcare team. We believe that this program offers a comprehensive and evidence-based approach to weight management, empowering patients to transform their lives and achieve lasting results.

Disclaimer: This policy is intended for informational purposes only and does not constitute medical advice. Please consult with our healthcare team to determine if this program is right for you.