Aetna

Any advice on possible surprise attacks from Aetna PPO? I really would appreciate infor you may have. Just trying to be proactive here....LOL

I had my surgery 4yrs ago and back then, everything went really smoothly. The only thing they wanted was proof from previous doctors that I had tried to lose weight through them...

Hi, Janice - I have Aetna PPO and was approved at first submission. I printed the terms from my policy, and checked them all off as I met them, and had my PCP include this in my medical file (the weight I lost each month, the exercise I was doing each month, the behavioral mod therapy I was doing each month). I included a full copy of my medical file (5 years history) and the proof of compliance with pre-surgical diet program (above) when they submitted my request to Aetna. My understanding from the folks who deal with Aetna for approval is that problem areas for folks have been: - failure to provide history of diet attempts in their medical file (they must have been medically supervised, which means your physician) - failure to have the doctor document the latest weight loss efforts completely, including exercise and behavior modification as well as the diet - no exercise regimen followed FYI I was part of the Living Well program at OSU, whi*****luded all of those components, and visited my doctor once a month during the diet phase to be sure my docs were updated. Best of luck! Lisa

Hi Janice Aetna can be tuff but I beat it after 9 months fighting and fulfilling their bullentine Policy Report located in their web site. Any questions e-mail me and I can show all the paper work that I had to do. Look up The Bullentine Policy Report and read thru it. It may sound hopeless but it can be done I'm 2 months post op and lost over 100 pounds and felling great Feel Free to contact me Dan O

I was approved in a month. But I know now they make you do a 6month diet program . GOOD LUCK

I would really appreciate seeing that paperwork. I just came from my consult and everything is good there. I also made my appointment with my family Dr to ensure all my records are correct and to schedule my cardiologist appointment, my sleep test and my esophageal scope. I was given the choice of laparscopic or open and after hearing all the statistics I went with the open. I want to make sure he can see everything!......LOL