okay the aetna insurance lady just confused the crap outta me

I have heard with aetna and their 6 month diet thing that you only need to see your regular PCP, but I called aetna and she said no you will also have to see a dietician and nutritionist also. I told her that I thought that you only had to see them if you were doing the 3 month program. She said no for both, and to take my printout of the requirements to my dr. and she could be able to tell me. Well I thought that was why I have their phone number, to call them if I had any questions- but apparently not!  Bama.mom sent me the stuff she did to get approved, twice. But for some reason I haven't got either one. I was just curious if anyone could tell me if they got approved by just going to their PCP?

I only went to my PCP. I did the 6 months instead of the 3 since I had a different insurance when I started, and they required the 6 months. So, I did 6 months with my PCP. I did have a meeting with my surgeon's nut, but that was like a week AFTER my 6 months was done. Aetna approved me on the first try (and for the DS--I think you are getting a DS, too, if memory serves).

http://www.aetna.com/cpb/medical/data/100_199/0157.html

Member must meet either criterion 1 (physician-supervised nutrition and exercise program) or criterion 2 (multidisciplinary surgical preparatory regimen):

For Criterion 1:

1. Physician-supervised nutrition and exercise program: Member has participated in physician-supervised nutrition and exercise program (including dietician consultation, low calorie diet, increased physical activity, and behavioral modification), documented in the medical record at each visit. This physician-supervised nutrition and exercise program must meet all of the following criteria:

   1. Nutrition and exercise program must be supervised and monitored by a physician working in cooperation with dieticians and/or nutritionists; and
   2. Nutrition and exercise program(s) must be for a cumulative total of 6 months or longer in duration and occur within 2 years prior to surgery, with participation in one program of at least three consecutive months. (Precertification may be made prior to completion of nutrition and exercise program as long as a cumulative of six months participation in nutrition and exercise program(s) will be completed prior to the date of surgery.); and

   3. Member's participation in a physician-supervised nutrition and exercise program must be documented in the medical record by an attending physician who supervised the member's participation. The nutrition and exercise program may be administered as part of the surgical preparative regimen, and participation in the nutrition and exercise program may be supervised by the surgeon who will perform the surgery or by some other physician. Note: A physician's summary letter is not sufficient documentation. Documentation should include medical records of physician's contemporaneous assessment of patient's progress throughout the course of the nutrition and exercise program. For members who participate in a physician-administered nutrition and exercise program (e.g., MediFast, OptiFast), program records documenting the member's participation and progress may substitute for physician medical records;