Aetna Insurance

Has anyone gotten around Aetna's requirement for a 6 month supervised program before surgery? If so, please advise. My insurance is running out and I've got to get this done!

I didn't get around it. They initially denied me for not having it even though I was already 4+ months into it. This was last year before they changed their policy where you could submit for approval prior to completing the diet. I think they are pretty strict on people meeting their requirements because their requirements are pretty simple compared to many other insurances. Have you met all of their other requirements (BMI>40 or 35-40 with co-morbidities, visits with dietician/nutritionist, "prescribed" exercise regimen, psych consult)? If you have met all of the other requirements and are at least part way through the 6 month diet, you might be able to get the approval. They also have another option of the 3 month "multidisciplinary" approach which is what places like OSU (and maybe Mt. Carmel) do for all their patients. Here's the link to the Aetna requirements. http://www.aetna.com/cpb/data/CPBA0157.html Good Luck

Carol, I checked that link listed below, I don't see any reason why we can't do the 3 month multi-disciplinary approach for you right through our office. Give Cathy a call at 513.559.2545 Sorry you're having so much trouble, it frustrates the heck out of me when insurance companies play these little games at the expense of their patient's health! Dr. C The Deaconess Surgical Weight Loss Center Cincinnati, Ohio

Will call tomorrow (Tuesday)! Thanks so much for your help. I knew there was something special about you. Regards, Carol

Dr. C This is Dan Otte here a patient of yours and thank you and your professional group for helping me to get approved. This is the approach that Jolene ur RD and I was shooting for. I want to thank you for taken on my case to get approved, not there yet but I have confessiness in you and your Staff. Atena decline me cause I did not meet their clincal Bullient policy, they said my primary doctor was weak with medical records, which is wrong. I am counting oun you Dr Curry & Staff we need a professional group like yours to do the job right. I will be at your next seminar Thursday, April 29 with two more people who I work with I highly recommended you. And I'm triing to get my brother to go who is a Doctor in Hebron, Kentucky Dr. Robert Otte MD He was checking into this surigical weight lost with my sister who had it done at UC. So I jump in and send all your online info to him. So I hope he will refer his patients to you Thanks Again and The WLS Butterfly Network knows all about you. Take Care Dan Otte

thanks Dan, we'll do our best to get you approved! Dr. C The Deaconess Surgical Weight Loss Center Cincinnati, Ohio

Does anyone know how I would find someone to do a phyc. consult? And, what exactly do they do there? Judy

Hi Carol try this approach Heather Stovall, ACS Complaint Analyst Consumer Services Division Ph. (614) 644-4908 Fax. (614) 719-1652 [email protected] www.ohioinsurance.gov Let's fight it I am I Care! Daniel