Attempting to get a revision approved by aetna ppo what info did you submit to get approved

Ok so I attempting to gather diet info 1 clinic out and out refused to write a letter verifing i was seen at there clinic. Just curious to see what kind of things did you submit to get approved.... i was even thinking of submitting a copy of my gym badge to show im a member of gym...would love to hear what things besides the doctor related stuff you submitted to get approved.

The clinic that refused to write a letter for you........ were you ever seen there?  You should get copies of your records.  Every insurance company is different, and has different requirements.  Do you have a copy of your policy?  Is it avaliable to obtain?  Can you view it online (on the website) just to see what exactly it covers?  There should be some requirements listed on your policy.

What would you be revising from?
Make sure to research ALL weight loss surgeries (DS included) so you can make an informed decision.

To answer your question yes i was seen at the clinic but as it was back in 2008/2009 they no longer have the records and refused to write a letter that i was a patient there without proof i.e.  a canceled check showing i paid for the program.. and even if i were able to get a canceled check per the rep at there corporate office there  was a high probability they wouldn't write the letter if there were no workers at the local clinic i attended that could remember me.

Have you asked the ins. co and surgeon what they require? They should both be able to provide you with a written list of requirements. Usually the insurance wants a fairly recent weight loss attempt and one that is supervised by your primary doc. No sense wasting time collecting things that the ins. or surgeon don't need. Good luck to you on your surgery.

I think it is going to depend on your individual company.  I did not require any hard core "proof" that I had joined the gym, etc.  I guess they took my word for it.

My insurance just needed approximate dates that I tried many weight loss diet/programs.  The six month supervised had to be just before/after I applied for approval.

Every Insurance company is different also your employer may have additional restrictions and or limitations. I have been on weigh****chers for the past year. I have diligently keep records online. I also see my gyno every year and thus have verified records of weight gain over the past 10 years. I have been dumping for the past 3 years. So all of this coupled with my surgeons verification  correctional or a revision to the RNY  I have in 2002 is medically necessary was all I needed. IT took 10 days after submission.

I was fortunate I know this I think timing may also be a factor as Insurance companies are seeing more and more failures and are open to accepting some people need an additional surgery to improve quality of life. I would start with a consultation with a surgeon. Also review your coverage to see if you qualify.

Good luck

Whit