Aetna's 3 month regimen - approved on first try

I have to admit that i was kind of doubtful. i just knew they were going to say I didn't do enough, or do it right, or something like that. Thankfully, i was wrong and got a date after the first submission. As a matter of fact, it turns out that my info was submitted on a Monday and I was approved on Thursday! I am scheduled for September 16!

Congratulations!

Congratulations on your approval.  I am wainting for my approval from Aetna. Dr sent it to them today.  Hope mine goes as fast and as good as yours.  I CANT WAIT!!!!

Give them four days and then start calling them everyday to check the status. That is what I did and I was approved in only two days.

What were you approved for?  I'm going to be submitting next week for the sleeve. I love to hear of approvals thru Aetna. Skye

Aetna has been great to work with. Once I figured out what they were looking for from the surgeons I work for, it was a breeze!
The biggest thing is making sure the 3 month program is a minimum of 90 days long. That was a real issue, they were denying because it was 88 days long! Like you will lose 100 pounds in 2 days, right?

FYI all Aetna patients:
Aetna looks for the following:

90 day supervised diet with monthly visits with MD or nut, documenting diet and exercise
letter from doc at beginning of diet
nut eval
letter from doc at end of diet still recommending surgery
2 years of obesity
psych eval

That's it! Crazy but true! I have sent them so little info and they still approved! I only need to send 15 or so pages to Aetna, but other insures want much more info!

CONGRATULATIONS~!!!!!


Bonnie

Hey Bonnie,

I have Aetna and just finished my six month diet but ended up gaining 5 pounds the hospital doesn't think I should submit the paperwor****il I lose some weight.  What do you think?  Thanks, Jaime

Aetna does not require any weight loss. Your surgeons office should know that!  THey should submit it right away. If they are not, then it is because they are worried you are not being compliant, and have reservations on doing surgery.
No one should be gaining weight on their diet. Our office has postponed surgery on those that gain. Medical studies suggest that those who do well on the pre-surgery diet are more successful than the ones who don't, and your doc wants the best results possible. Also, surgery is more difficult if someone gains right before surgery, my docs say. Then can tell when they are in your guts.
That might be why you are being held up.
Tell them to submit it and get in gear and lose a few pounds why you are waiting. Not only will you feel better, you will lower your risks during surgery.
Good luck!

Bonnie
RNY 6/3/05
264/154

Hi, did you do a six month diet?  If so did you lose any weight and if so how much?  I amjust curious because I just finised mine and I gained 5 pounds and the hospital doesn't want to submit my info until I lose some weight.  I have aetna too.  Thanks, Jaime