Is Your Practice Actually Ready to Scale a GLP-1 Program?
Growing a GLP-1 program is the easy part. Getting paid for it, consistently, is not. Payers can approve a claim today and recoup it months later if the chart doesn't tie comorbidities, BMI trends, and prior treatment history together, and even the new Medicare GLP-1 Bridge Program — $50 a month, no new prior authorization needed on refills — only pays out if a practice meets all four eligibility requirements and documents accordingly.
Dr. Brian Bluth, Gabbi Gifford, and Kari Rayl walk through what it actually takes to run a compliant, reimbursable GLP-1 and insulin resistance program: the documentation that gets claims approved instead of denied, how the Medicare Bridge Program works end to end, and what it takes operationally to manage patient follow-up, coding, and scheduling as a program scales.
Our speakers
Dr. Brian Bluth
Family Medicine Physician, Weatherford, Oklahoma
Board-certified family medicine physician running a GLP-1 and insulin resistance program at Metabolic Centers for Excellence in Oklahoma.
Gabbi Gifford
Billing & Coding Specialist, Clarity Health Systems
Billing and coding specialist focused on getting GLP-1 and obesity-related claims documented, approved, and reimbursed.
Kari Rayl
Functional Medicine Nutritionist
Nutritionist supporting physician-led diabetic reversal and weight-loss programs with functional medicine-based patient care.
Highlights
- The documentation that gets GLP-1 claims approved, and the gaps that get them denied or recouped later
- How the Medicare GLP-1 Bridge Program works: four eligibility requirements, $50 a month, no new prior auth on refills
- Why comorbidities, BMI trends, and prior treatment history all need to connect in the chart, not sit as isolated codes
- What it takes operationally to manage patient follow-up, coding, and scheduling as a GLP-1 program scales
- Why most independent practices don't have the in-house bandwidth to run this level of billing and support alone