aetna insurance help?

 Hi all,

I have an insurance question. My insurance requires a 6 month supervised diet or a multi-disciplinary surgical preparatory regimen for 3 months with certain criteria’s met. I am doing the 3 month program in my state where they think I am having one of their surgeries they offer which I am not. I am having the ds surgery which they don’t  do here or really anywhere near me. I guess what I’m asking is after making it  through all the criteria should I continue through this entire program right through to the surgeon (which I have not yet met) and let them approve it, then go to my DS surgeon’s office and see if they can get that one approved afterwards? I have one more Nut appointment left then all my steps for the insurance has been met the only thing I’d have to left to do would be to meet the surgeon and let them know what surgery I wanted then they would submit the approval. There is no way I can do all this from so far away from the ds surgery. Has anyone else been through this or any suggestions? I have aetna  insurance.

 

Sorry if this is confusing I found it hard to explain.

 

Thanks,

Trish

 I don't have Aetna but I am doing the same thing. I want a DS but am pretending that I want a sleeve and I have gotten all of the pre-op stuff done here. I have met with the DS surgeon though and I have been in touch with their office to help coordinate things.

I was denied for a revision May 2011 and then fought to the DMH****il 11/11. I just applied again with additional information. So I can't tell you how it will turn out.

It did NOT work to have the local doc submit for authorization last time. I thought if I could get a revision approved, I could change the surgery type later. Didn't work... With my insurance, requirements for the DS (the surgery I want) are different, so you'd better check that out.

This time I had the out of town surgoen's office send in the authorization, but I did all of the work locally. Does that make sense? In your case, it might be easier for you to do the same thing. Just have your records transferred to the new surgeon when you are finished with everything!

 Hi,
I'm in touch with both also, I have been sending some of my stuff out to GHP I guess I'll just wait for the last appointment and gather it all up. My requirements for surgery are the same for any WLS I don't have to meet anything different to have the DS thank goodness. 

They keep asking me which surgery I want, I tell them I havent made up my mind seeing they don't offer the one I want. Just seems that its always much more difficult dealing with insurance compaines. Good luck with your approval. :)

 Thanks- you too!