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Topic: RE: FINALLY!!! APPROVED!!!! THANK YOU!
Can you send me a copy of the letters? [email protected]
Topic: 5 year weight history - BMI under 35
Anyone have issues with 5 year weight history for insurance purposes and some years that your BMI didn't quiet meet the obesity level
Topic: RE: 6 month diet/gained weight!?
For those of you that gained weight did you gain over all months of the insurance required diet or just during the last month? Overall, I lost 14lbs it was just the final month where I ended up being the same weight as the previous month (looked like I had gained but really had just stayed the same). I had full 6 months not 6 visits. I debate going for one more month...should I have a visit in November or just submit? I don't know if it really matters..
Topic: RE: Peer to Peer, succesful!!!!
Congratulations!!! That is wonderful that your surgeon fought for you! Good luck with your surgery!
Nan
Nan
HW 300 / SW 280 / CW 138 / GW 140
Hit Goal 4/2/2010
Topic: RE: FINALLY!!! APPROVED!!!! THANK YOU!
Maria!!!!! Congratulations!!!!! This is GREAT news!! I am very happy for you!!
Nan
Nan
Nan
HW 300 / SW 280 / CW 138 / GW 140
Hit Goal 4/2/2010
Topic: Peer to Peer, succesful!!!!
Hi all, I saw my surgeon today and we discussed him doing a peer to peer with the medical director at CIGNA. He didn't think that it would make a difference but promised he would fight for me. Guess what! Success!!! I'm still in shock! Guess he had to go through every visit with him since band was placed in 2007 and stress the reasons over and over again as to why I'm having intolerance issues with the band. Got my approval!! Scheduled for sleeve surgery on December 8th. i love Dr. Srikanth!!!
Topic: RE: 6 month diet/gained weight!?
My Aetna nurse case manager did indicate that my weight gain may have been a factor in my first appeal denial, so I went for one more month and showed a small loss overall, and then was approved on second appeal. However, this was just the opinion of the nurse case manager. Also - please make sure that your six month program was a full six month- not just six visits, that seemed to stall me as well!
Good luck!
Good luck!
Topic: FINALLY!!! APPROVED!!!! THANK YOU!
Hi all-
Good news, I am finally approved on second appeal.
Like many - I used Nan's letters, stuck to the specific details on what they were asking for and used all available sources to gather info for the appeal.
I hope to have a date later this week.
Thank you all for all of your support!
Maria
Good news, I am finally approved on second appeal.
Like many - I used Nan's letters, stuck to the specific details on what they were asking for and used all available sources to gather info for the appeal.
I hope to have a date later this week.
Thank you all for all of your support!
Maria
Topic: RE: Medical Spending Account
When my daughter had her RNY surgery last May it was covered by insurance, but we had to pay $1,880 out of pocket. I turned that into my FSA (Flexible Spending Account) and it was covered.
Nan
Nan
HW 300 / SW 280 / CW 138 / GW 140
Hit Goal 4/2/2010
Topic: RE: DENIED BY AETNA ON APPEAL
Hi Rosie,
Would you mind sending me the letters that you have drafted? I am concerned because I have to a 5 year weight history and my weight history hasn't always been with a BMI of 35 so I need all the help I can get to get the insurance company to approve. I'm trying to do surgery prior to the end of the year so I need a quick approval. Thanks! My email address is [email protected]!
Would you mind sending me the letters that you have drafted? I am concerned because I have to a 5 year weight history and my weight history hasn't always been with a BMI of 35 so I need all the help I can get to get the insurance company to approve. I'm trying to do surgery prior to the end of the year so I need a quick approval. Thanks! My email address is [email protected]!
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