DENIED by Aetna- Back to the Drawing Board

Hi all,

Haven't written because I could barely even think of this without breakdown...  I was denied by Aetna Choice + POS for lack of documentation of my six month program, even though I had 7 months of chart notes, noting diet, exercise and behavior mod.  What I did was not through a surgeons office however, so I guess I am going to have to do that to get there...  thinking of trying to do the 3 month program...

just really bummed, depressed, hopeless... etc...

Maria

im so sorry,i hope all works out for you .i am waiting to hear from insurance,everything else is done

I am sooo sorry for your set back. I am wondering if there is a way to find out exactly whatthey think you are missing. Maybe you can supply whatever they want and avoid starting over???? You are in my thoughts! Keep your chin up and let me know how it goes.

Maria,

What was submitted to Aetna?  They require the 6 months diet to be supervised by your physician so if it was six months worth of Weigh****chers, for example, it will get denied. For the 6 month physician supervised diet you need to go in to your physician's office and complete 6 months worth (7 visits) of documentation whi*****luded noting you are there for weight loss, your weight, height, bmi, diet, exercise, etc.....

The 3 month program is a little tougher because you need a visit with a dietician along with your visits with your pcp who will document your diet, exercise and they also look for documentation for behavior modification. 

If you feel you have met their requirements, appeal! 
Good luck to you!
Nan