Ive been denied by aetna

hello everyone i am trying to stay positive but i have a question. My surgeon is dr. hart at atlanta bariatrics and aetna denied me although i had six months of supervised diet records. They stated that i needed 6 monthd diet and exercise [rogram supervised. Is anyone familiar eith that. I can not afford a gym membership what does that mean for me? how else are you supposed to get supervised exercise.........                                                            Trying not to cry!!!!Natasha

It may be the way te doctor wo did your supervised diet wrote things up.  Because wen you went for our ceckups tey should have also asked about your exercise routine as well. So, you ma just need an amended letter from that doctor.

Try Keva & Karen at the Atlanta Welness Center, the do bothe hte nutrtionist and exercise prgram. Stay tuned I will the telephone number for you.  It seems like they would have told you at the surgeons office, Well what should I expect my sugeon'd=s office didn't tell me either I learned just by talking to all the wonderful people her on OH, By the way the fee will be $100 first vist then I then $75 for the other 2 mnths, my first appointment with them will be May 3oth.  Will the surgeons office hep you with the appeal p[rocess.

I have aetna as well....and by supervised exercise it does not mean gym membership.  I was on a doctor supervised exercise program which required monthly calendars where I earned daily points for my exercise and had no problem when it came time for approval.   It is something my surgeon required for all of his patients.

Thanxs for all the info i do bellieve that it was the way they noted the charts Dr. hart didnt do it his nutritionist rachel did the notes she told me all i had to do was come in once a month and she would note my weigh in and when i came drop off a food record she would chart and submit. If they denied me i dont feel it was my fault because i did everything they told me to do. Thank you for any info you can give.

Im so sorry to hear about your denial!    I have Aetna as well and have chosen Dr Hart as my dr.  I have just started my process but have been told tha the weight  documentation has to be a DR and not a nutritionist.  Are they telling you anything else you can try to get it pushed throught? Wishing you the best!! Ginger 

I have aetna and I used AB and  certainly didn't have an exercise record.  It has to be the way it was worded.  You can appeal, just make sure you know what they need to see and get your documents in order.  Good luck.

AETNA  DOES REQUIRE A 6 MONTH NUTRITION AND EXERCISE PROGRAM. MY NUTRITIONIST DOCUMENTED WEIGHT AND EXERCISE PROGRESS AT EACH VISIT. AETNA ALSO REQUIRES THAT MEDICAL RECORDS BE SENT . I DID THIS WITH DR.DUNCAN'S OFFICE. ATLANTA MEDICAL CENTER ALSO OFFERS THIS  COMBINED PROGRAM.

I have aetna and had my surgery on Tuesday.  I did not have a MD supervised exercise program. I went to the NUT for three months (1X each month) and to my PCP the same. My bariatric office had told me what to make sure he put in his notes. They  were...what kind of diet I was following (calorie wise), specifically what exercise I was doing (walking) and that I was seeing the nutritionist monthy. Plus, how my comorbitites were doing and a documented weight. I was approved the first submission. Each appointment I made sure he knew what to write in the notes. I am sure he wanted to choke me but I got approved. I saw the same PCP each time for continuity. My insurance paid for the nut, with my copay only. Good Luck.

Don't cry as to youmay make me cry, I just got denied for my appeal yesterday for the same thing. I had to go through a three month supervised excersie and diet and the diet and excersie was not in the notes of my medical records nor the letter the doctor wrote.   I was not told this by my surgeon office either. So now I have to appeal with my employer before the paperwork can go back to United Healthcare.