Aetna.. Almost thru with 3 month PSPP (Presurgical mumbo jumbo)

Hi everyone! Well I have just one month to go before submitting my paper work for the 3 month pre surgical prep program. I get the feeling that my surgeon's office is not going to be super helpful or super careful when submitting to my insurance, so I want to have everything ready and just hand it to them to include in whatever they send. Any tips? Here is what I have been doing: I have been going to see the surgeon once a month, the next visit will be my 4th visit. Also I have been seeing a councelor for the mystery "behavior modification" she was instrumental in helping me to quit smoking. I have a nutritionist that I also have seen every month, and there is a personal trainer that I have seen every month as well. Now, my question is, what EXACTLY do I need from them? If anyone who has been successful with AETNA and the 3 month pre surgical #$#(%& would be so kind as to email me and maybe even let me see what they submitted, I would really appreciate it. No need to reinvent the wheel if someone here has been successful!! Thanks everyone... goodluck in your journeys! Theresa Johnson

I haven't done the three month thing. I seemed to confusing to me. I've finished with my six month diet. Seen the dietician, got the psych evaluation done, gathered every medical record from now going back to 1996. I've got letters of recommendation from the dietician and two doctors. I've gone through all my medical records and circled everything pertinent. Weeded out the records, such as pap smear stuff, that wouldn't help me, make triple photocopies of everything since I trust no one to hang onto my stuff. I'm sending my stuff into the surgeon's office this week. My only concerns are that the six month diet has been broken up into a fourth month stint followed by a two month stint. Long story there, I have my reasons. And Aetna says the diet does not have to be consecutive. Only three months of it has to be consecutive. Also, the only weight I have recorded that is over 5 years old is 7 pounds, according to the recorded height, to low to be at a 40 BMI. Now if they go off the height the surgeon's office measured me at, which was on full inch shorter, than I'm ok there. Well, time will tell and I will fight the good fight. Good luck to you. Lynda

I just compleated my 3mo stink on that and it is being submitted, I called Aetnas appeal nurse who is handling my file, dont have to appeal per se as my union is demanding benefits for me. and they (who are the judges) didnt have a clue that it even existed. they didnt have to newest cpb 157. for 4/19/05, so i ended up explaining it to them. call them. and ask what they want, you might be surprised,demand that they tell you what they are requesting, and dont let them cop out with "Your surgeons office will know" crap