aetna ppo michigan what in the heck is a behavior modification program

tattoobabe
on 10/20/12 8:39 pm - MI
does anyone have this insurance...im hoping for a revision but it appears i have to jump through the necessary hopes to get this thing done.....the first things they are asking for is doable getting proof the bmi was between 35 to 40 for 2 yrs. doing  a diet program for 6 months... i think i can get that info....fingers crossed the medical weight loss clinic keeps files. the last one may be biggest hoop to jump through finding an dietician or nutritionist. If insurance covers i may even be able to do that but the one that confuses me is that i have to behavior modification program...what the hell is that? does anyone know?
walterswife
on 10/21/12 9:06 pm
I don't have Aetna but what you are talking about is standard for many if not most companies. Check with your surgeon re the nutritionist. Many practices require that you see a specific nutritionist pre op so you can get instructions as to how and what to eat post op for that particular practice. Every dr is different. My visit was not covered by insurance b/c I was not diabetic. I think it as around $125.00 (can't remember the exact amount).

The syrgeon's office can make recommendations re the psychologist which is usually one extended visit. My insurance company paid the bulk of the cost. My co-pay was around $35.00. Your best bet is to get someone who does those regularly. Before I found tye psychologist who did my evaluation, someone else that I spoke to wanted to charge me $1200 and wouldn't accept my insurance.

Also remember that the surgeon can place additional requirements on you over and above what Aetna requires. Start with the surgoen's office First on all referrals. Then relax. It is much too early in the process for you to get frustrated.

HW 240/ SW 229/ GW 146/CW 125; OH Support Group Leader   

Starting size:  18W-20;  Present size: 0 or 2; 5'5-1/2" tall. 
Current BMI 20.4 as of 2/13/2013 (normal for the first time in my life).
Goal weight reached on 8/12/2010; As of 1/13/2013, 21 pounds below goal

pineview01
on 10/22/12 11:31 am, edited 10/22/12 11:32 am - Davison, MI
My clinic is the one that is making me do the behavior modification program for conversion from band to sleeve.  The told me who I have to see and I have to do 6 sessions with her.  I have already done 8 by the time the insurace agreed to let me do the Psych Eval which the insurance and center are requiring.  The Psych Eval is the one I had to do first time and includes the MMPI-2.  I too have to do the 6 months diet with doctor, I used my documentation from caloriecount.com for my doctor.  Your Medical Weight Lose will work if they give you the documentation.  As far as nutritionist, I have to do that thru the center and she cost $45 per 15 minute session, not covered my my insurance.

Bottom line for me the center said who I could see.

Good luck!

BAND REMOVED 9-4-12-fought insurance to get sleeve and won! Sleeved 1/22/13! Five years out and trying to get that last 15 pounds back off.

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