Healthy LIFE Course Details

Building a Healthy LIFE that Will Last

The Healthy LIFE® pediatric weight management program is a comprehensive group and individual program for weight management designed to give youth (ages 8-18) and their parents the skills and information needed for lifelong weight management.

Overview of Course Structure and Contents:

Part one—Assessment (pre and post) —is where the program director collects information through questionnaires and interviews with the participating family and identifies the following: behaviors affecting weight; behaviors most easily changed; barriers that need problem solving; and new skills that will have the biggest impact on weight. Assessment also includes an optional body composition scan (state-of-the-art DXA), BMI and body fat, and waist/hip measurements. Assessment is repeated at the end of the group to measure progress and set goals for continued success.

Part-two—Group—immerses the family in an intensive learning experience so that the foundations of healthy weight management can be mastered.

Weekly groups are 6-8pm on Thursday evenings (can be 5:30-7:30 if families prefer)

• Individual and group review of accomplishments and progress towards goals
• Private non-judgmental “weigh in” on body composition scale
• Nutrition education with registered dietitian
• Physical activity participation with exercise instructor
• Healthy behavioral skills training with Ph.D. psychologist
• Goal-setting workshop with psychologist

Part-three—Individual Coaching—is provided during two 30-minute appointments during the first 3 months after the groups are completed. Follow-up behavioral coaching assists participants in keeping up their progress by setting personalized weekly goals, adding accountability for behavior, engaging in problem solving, and strengthening healthy lifestyle skills. Additional follow-up coaching sessions of 15-30 minutes can continue, for an additional charge, at useful intervals throughout the first year and beyond.

Tuition: Usual payment installments: $400 (assessment) $400 (week 4), $378 (week 8). Total=$1078. Other payment plans are available.

Insurance reimbursement for Healthy LIFE:

Healthy LIFE does not accept insurance as a form of payment. Payments for the program are made by the parent or parents of the patient as per the contract. Parents can ask for an insurance-ready receipt for sessions attended (regular or make up sessions) that they can submit to their behavioral health insurance plans (same as mental health) f. It will be out-of-network since Dr. Gill is not a provider on any insurance plan. Tax ID# for Dr. Gill is 04-3834134.

FLEXIBLE SPENDING FOR HEALTH CARE plans DO allow use of non-taxed dollars towards a medically necessary WEIGHT MANAGEMENT PROGRAM (all children in our program qualify). Therefore, if you have set aside dollars or can set aside these flexible spending funds in the upcoming year, our program receipts can be used to get the funds reimbursed.

If you intend on being reimbursed by your health insurance plan, you may wish to call your provider ahead of time and find out if the following CPT Codes would be reimbursed and at what percentage.
           
These behavioral health/behavioral medicine codes are:

• 96150 – Health and behavior assessment (initial face-to-face assessment)
• 96151 – Health and behavior re-assessment (review of progress after group)
• 96153 – Health and behavior intervention in a group (for the 14 weeks of group)
• 96154/96152 – Health and behavior intervention, face-to-face (1-on-1 sessions with/without parent)

Medical Diagnosis:

If your child has an additional medical diagnosis besides obesity you may get coverage easier if you remind us to put this on your Healthy LIFE receipts. These may include: diabetes, type 2 (250.82), hyperlipidemia (high cholesterol 272.4), hyperinsulinemia (251.1), Polycystic Ovarian Syndrome (PCOS-256.4).

Behavioral Health Diagnosis: a common option is to use a behavioral/mental health diagnosis and mental health codes if your child qualifies (we can discuss and confirm during diagnostic interview). Common diagnoses include: compulsive eating or binge eating, excessive anxiety, especially about weight or body, depressed mood exacerbated by weight or teasing about weight, other mental health diagnosis already being treated and for which learning healthy lifestyle and weight management skills would clearly help symptoms.

The mental health treatment codes are:

• 90847 – Family Therapy (We use this code for initial goal setting visit with patient and family)
• 90849 – Multi-Family Group Psychotherapy or 90853 – Group Psychotherapy
• 90806 – Individual behavior modifying and supportive therapy, 45-50 minutes
• 90804 – Individual behavior modifying and supportive therapy, 20-30 minutes
  

Please be careful to specify that these services would be provided by an out of network provider and ask your insurance provider what your behavioral health deductible is, so you know how much you have to pay out of pocket before insurance will cover. This is similar to insurance reimbursement for seeing a therapist or going to a behavioral treatment group.

If they ask, you can give Dr. Gill’s Tax ID#04-3834134 which will be labeled “Pediatric Psychiatry.”

Upon request, we will provide you receipts for the dates of the groups, assessments and individual sessions you have completed. We cannot provide receipts for dates that have not yet occurred or classes that were skipped, since insurances will not reimburse for a service you have not received. If you make up for the class you skipped then you may receive a receipt for that make-up class or individual make-up meeting.

Healthy LIFE Important Dates

We are currently enrolling for the next group.

If you wish to inquire about groups or information sessions, please email us at: HealthyLife@barnabashealth.org or call (973) 322-7620.

FOR DIRECTIONS

INDIVIDUAL COACHING and counseling for weight management or any issues related to weight, lifestyle change, eating patterns, body image or emotional eating is also available. Please email Dr. Gill directly at dgill@barnabashealth.org.