Just waiting...
ok... so all of the paperwork has been submitted to Aetna and now I wait! I will let you all know when I hear. But I thought I would share what I did (my surgeon's office said they wish all the patients would do this). I copied the Aetna Clinical Policy Bulletin into Word and under each requirement I inserted what I did to meet/exceed that criteria. That document along with the chart notes from my pcp, nutritionist, psych eval and surgeon were faxed to the insurance. The document was 6 pages of explanation of how I met the requirements and what I did to complete the 3-month multi-disciplinary surgical prep. And the chart notes served as the verification of those explanations.
When I initially talked with Aetna back in January I was told to make the documentation as thorough as possible and to put it in a point by point type of document. That way it is clear for the person reviewing how all the criteria are met. So... I'll let you know if it works!
My surgery is tentatively scheduled for May 22nd!
That's a great idea!!! Best wishes to you!!! I really appreciate the advice. I have one more appointment next week then my request can be sent off. I'm going to use your tip.
Well so far so good... the nurse from Aetna reviewing the paperwork called the surgeon's office already and she was done with her part and she couldn't see anything that had been left out. And she said it was so thorough and easy to follow she didn't see anything missing. She commented on how detailed it was and she wished others were that easy. So now it gets forwarded to the Aetna's doctor for review and the final say!
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