6 month diet Aetna. Resubmitting info.

Evening Good People! Hope all is going well for everyone. I was denied in November 2004 for lack of 6 month diet history. So, I began my 6 month diet, nutritionist, exercise regimen in January. I have PCP notes from each visit and just did visit number 5 this week. Do you think it's okay to submit with the 5 month history so far? Any advise would be Thanks

I also started my 6 month diet with Aetna in January also and was told by the bariatric insurance coodinator as well as many people on this board who were approved by Aetna, that June would be the end of the six month diet because they needed six monthly visits so your first visit in January counts towards the six. I have not submitted yet but I will be submitting in two weeks, I am not sure if you meant you were going to send it as of May or June. June would be six months and it is almost here! Hope this helps!

Your 6 months it will be up in June. So your looking good My year of dieting was up on October 2004. I saw my PCP at the end of September 2004 and my surgeons office sent the paper work in to the insurance company at the end of September 2004. I called and asked if that was OK and was told the insurance companies give you a couple of weeks leeway. Good luck Donna 338/219 -119

Thanks for the info ladies. Donna, I submitted my info with the 5 consecutive months from Jan-May. I actually had 7 months info because I had docters notes from July & Nov of 2004 as well. I figure if they deny me again I will have completed my 6 month. Hopefully my surgeons office will send it to the insurance company this week. Congratulations on your weightloss so far. You must feel amazing. Luv, Courtney

Thanks Courtney, I do feel wonderful and you'll soon feel the same way Donna 338/219 -119

Don't have an answer for ya but I have kind of the same problem. Kind of. I did four months last summer of the six months diet then stopped because of a family crisis. Well, I stopped going to my doctor anyway. I resumed the diet last month and the end of June will be month six. The clinical policy bulletin says the diet does not have to be consecutive. Only three months of it has to be consecutive. I'll be sending in my paperwork the end of this month and I hope I don't get denied because my six months weren't continuous. I'm all mentally geared up for a fight though if I get denied. So I'm not really that worried. Lynda D.

Good luck with your resubmission I hope all goes well for you. I have had many problems with aetna and am working on my second appeal.From my understanding that you can submit after three mos. if there hasnt been any prgress in weight loss I guess sord of to prove that other methods dont work. Im not 100% sure if thats true but its what I have heard. I my self was denied initially and on my first appeal and retained legal council for my second. My attorney and I go before a medical review panel this week. Wish me luck! All of my best to you and good luck! Lorie