Healthy LIFE Course Details

Building a Healthy LIFE that Will Last

The Healthy LIFE® pediatric weight management program is a 6 month comprehensive program for weight management designed to give youth (8-18) and their parents the skills and information needed for lifelong weight management. Healthy LIFE includes both individualized and group components.
 
Overview of Course Structure and Contents:

The Healthy LIFE program is structured in four parts:

Part one—Assessment—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 a state-of-the art body composition scan, body measurements, and fitness challenges. Assessment is repeated at the end of the group to measure progress and set goals for continued success.

Part-two—Cornerstones—immerses the family for the first 8 weeks in an intensive learning experience so that the foundations of healthy weight management can be mastered.

Part-three—Building Blocks—takes place during the next 8 weeks and builds on what was learned in Cornerstones so that healthy living becomes more of a habit. Additional skills and knowledge are layered on and participants receive guidance in using these skills to manage a variety of challenging situations.

Part four—Individual Coaching—is provided during two 30-minute appointments during the first 2 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. Follow-up coaching sessions of 15-30 minutes can continue, for an additional charge, at useful intervals throughout the first year and beyond.

Tuition:  Temporarily reduced to $1598 paid in installments (normal price is $2250). This price includes: 32 hours of group treatment with professional multidisciplinary staff,  4 hours of individual assessment with program director, take-home fitness equipment and instructions, weekly educational hand-outs , two state-of-the art body composition DEXA scans, and individual coaching sessions with program director after group ends (also during group to make-up for occasional missed group sessions) The Healthy LIFE program contract specifies our usual payment intervals.

Part one, “Assessment”  includes pre- and post-group evaluations scheduled at family’s convenience. 

• Individual behavioral assessment with Ph.D. psychologist
• Individual fitness evaluation
• Body circumference measurements (e.g., waist size)
• Body weight, height, BMI, and body composition by Tanita scale
• State-of-the art Body Composition DEXA scan (safe, reliable, and valuable)

Part two, “Cornerstones” builds core skills for weight management.

Eight 2.5 hour weekly group sessions (5:30-8 pm on Thursday evenings)

• Review of accomplishments and behavioral progress made by each participant
• Body composition scale “weigh in” and feedback
• 45-60 minutes of nutrition education with registered dietitian
• 20-30 minutes of physical activity participation with exercise instructor
• 30 minutes of healthy lifestyle behavioral skills training with clinical psychologist
• Goal-setting workshop with psychologist

Part three, “Building Blocks” refines day-to-day choices with advanced skills
 
Eight  1.5 hour weekly group sessions (6-7:30pm on Thursday nights)

• Provides  same components as Cornerstones but education portions are shortened 

Part four, “Individual Coaching” assists participants in keeping up their progress

Two 30-min individual sessions scheduled during the first two months after group ends.  

It is highly recommended, based on extensive research, that people making a lifestyle change receive professional support for up to a year. Individual meetings are an ideal way to provide this support when group treatment ends because they are flexibly scheduled and tailored to each participant’s educational, motivational, and clinical needs.  Sessions assists participants in keeping up their progress by setting personalized weekly goals, adding accountability for behavior, engaging in problem solving, working through any motivational barriers to change, and strengthening healthy lifestyle skills.

After the two sessions included with tuition are completed, Dr. Gill will help each family determine what frequency and duration of ongoing support is needed, and will schedule individual appointments with participating families. Individual meetings can be 15, 30, or 60 minutes long. Cost is $48 per 15 minutes as per current Saint Barnabas fee schedule.

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 are given receipts upon request if they plan to submit to their insurance company. Some insurance providers may reimburse for these services, others may not.

However, we are happy to tell you that FLEXIBLE SPENDING FOR HEALTH CARE plans DO ALLOW use of non-taxed dollars dollars TOWARDS A medically necessary WEIGHT MANAGEMENT PROGRAM (all children in our program qualify due to BMI>95%ile).  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 16 weeks of group)
• 96154 – Health and behavior intervention, face-to-face (for 1-on-1 coaching sessions)

Please be careful to specify that these services would be provided by an out of network provider that does not accept insurance. 

“I am planning on having my child join a weight management program, which his/her doctor referred us to.  My child was diagnosed with an abnormal weight gain (ICD-10 code 783.1 *) and my doctor believes that we should do this program in order to improve his/her health.  This program is out of network and does not accept insurance.  Would I be reimbursed for these services?  The CPT codes that they bill for are 96150, 96151, and 96153.  These codes fall under behavioral health/mental health in your plan.  What percentage am I entitled to?” “Also, what is my mental health deductible and how much of it have I already met?”

* If your child has an additional medical diagnosis besides obesity you may get coverage easier if you report this to your insurance company (and tell us to use this on your Healthy LIFE receipts). If applicable, please be sure to mention the following diagnoses : diabetes, type 2 (250.82), hyperlipidemia (high cholesterol 272.4), hyperinsulinemia (251.1) obesity (278.00 ), morbid obesity (278.1)

Please find out if a letter of medical necessity or diagnosis would be required by your insurance provider.

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.

Mental Health codes:

Because the instructor is a clinical psychologist, she can offer some participants a mental health alternative to billing the program as a behavioral medicine intervention. This would apply if a child has significant anxiety or depression that would be improved by weight reduction and/or healthy lifestyle, or if her or she exhibits frequent emotional eating , compulsive eating, bingeing, or other eating disorder symptoms.  In this case the CPT codes would be:

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@sbhcs.com or call
(973)322-7496.

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@sbhcs.com. 

Special Event

Healthy LIFE Super Seminar
Key Facts and Skills for Weight Management

This fun and educational 2 1/2 -hour seminar will teach many basics of healthy weight management, including nutrition information, behavioral skills, and the importance of enjoyable exercise. This seminar is perfect for kids and teens who tend to put on weight more easily than others. It is the most affordable educational option available to our overweight patients and their families and a great place to start!

Date:  Thursday Evening, September 10, 2009    
Time: 5:30-8:00   Cost: $100/family
Instructor:   Dr. Debra Gill, Psychologist specializing in weight management
Place: Saint Barnabas Ambulatory Care Center (Classroom A and B)

Skills and Topics Covered:

• Reducing calories while increasing enjoyment—deprivation-free weight loss
  
  
• Healthy Everyday Foods vs. Not-So-Healthy Sometimes foods
  
  
• Have your cake and TASTE it too! (Slow, savoring, and mindful eating)
  
  
• Size matters!  Tips and tricks for controlling portions
  
  
• What you see is what you want! (or, out of sight, out of mind)
  
  
• Stop! … in the name of Fullness; and asking “Am I really Hungry?”
  
  
• What’s in a label anyway?  (Basics of reading food labels and daily nutrition goals)
  
  
• Asking “Is it worth it”?   Maximizing nutrition and enjoyment for your calories.
  
  
• Activity:  Exercise, “Exerplay” and finding time to MOVE

The Healthy LIFE Super Seminar provides our overweight patients at the Saint Barnabas Pediatric Specialty Center with a foundation of knowledge and skills that we build on with the Healthy LIFE behavioral coaching program.

The Healthy LIFE behavioral coaching program involves 4-8 personalized visits where each participant will see Debra Gill, Ph.D., our weight management expert, as well as one of four pediatric endocrinologists (MD’s). Visits will not carry additional costs above your usual costs for an endocrine doctor visit. However, participants must have attended the Healthy LIFE Super Seminar (held approximately once a month) in order to learn the techniques they will be putting into action during the Healthy LIFE behavioral coaching program.  (The cost of Dr. Gill’s weight management coaching visits is normally $192 per hour, so patients save a lot by participating in this combined of seminar plus coaching.

In the Healthy LIFE behavioral coaching program, participants will develop personal strategies for weight management, set specific and achievable goals, have accountability, receive regular checks of weight, body fat and muscle, practice planning and problem-solving, and receive positive feedback for accomplishments. You will learn more about how the behavioral coaching program works when you attend the Super Seminar.  We look forward to seeing you there.

Please download and complete the attached registration form and send any questions directly to Dr. Gill (dgill@sbhcs.com) or leave her a message at 973-322-7620.