Aetna Insurance anyone??
Hi everyone - I'm new to OH and have been reading thru some old posts regarding Aetna insurance. I have Aetna PPO thru my work and they do cover WLS. I have followed the Clinical Bulletin #0157 and trying to qualify for the 3 month vs 6 month plan.
I started with my PCP on 9/29 and with my dietician on 10/13. That would mean my 90 days would be up with my PCP on 12/29 and with my dietician on 1/11. My surgeon's office sent in my request for approval too soon and I was denied last week, even though they knew I still had another appt with my Doctor. Anyways, I was denied because I didn't have my 90 or 180 days in.
Some of the older posts from this summer were stating that in order to qualify for the 90 day multidisciplinary pre-surgery regimen you needed to have two letters, one stating that you started the program and one stating that you have finished the program. And that these letters needed to be from your surgeon. Also you need a letter from your physician too. I meet all of the requirements (BMI of 47) and have the two year minimum obesity requirement. I have been seeing my PCP and my dietician monthly along with attending WW.
Has anyone been approved for the three month multidisciplinary program and been approved?? Tips for being approved??
Thanks for any help you have.
Nan