Aetna sent the dreaded "Need more info" letter today.

Hi group, I've been a member for a little while now...mostly I lurk and post a little here and there. I've been to see my surgeon and my paperwork has been sent in. Insurance received it on 3/4/04. During the past year I have been trying to get ALL my ducks in a row so I could get approved. I KEPT telling my PCP that I NEEDED a 6 month medically supervised diet. To which he answered that since I was in his office and he weighed me monthly...this would count as the 6 month supervised diet. WRONG! Back in late November I raised such a stink that he FINALLY sent me to a dietician and I have been seeing her monthly...Dec, Jan, Feb, and March.... now you can see where I'm going with this...my paperwork has already been sent in for approval and now they want more info on my "6 MONTH MEDICALLY SUPERVISED DIET" that I only have 4 months of...and would have had completed it...if only my pcp had listened to me! I've learned most everything that I know of wls here on this site...and all my gut instincts and info that I have learned here told me that I was going to have some problems in this area.....oh well... nothing has ever come "EASY" for me...worst case scenario is that I have to wait 2 more months and re-apply? hmmmmmm I guess our PCP's need to have a little more knowledge on what insurance companies really want! Oh well..think I'll go and relax and try not and think about this too much as it may make me crazy! wahhhhhhhhhhhhhhhhh! Terri

Terri, good luck with this, I pray that those two months fly by. And I agree on educating PCP's about our needs!!

Terri, Girl, Im right there with you in the same boat with Aetna. Its also been 4 months for me(out of the 6 required). Ive got my dr's notes, exercise notes (from physical therapy program) and everything else and Im about to send in my first appeal letter next week. I was denied in Dec. 2003 for lack of the 6 month diet. Ive read what they require but its still a little unclear to me. Also when I called Aetna, they were pretty clueless as well. I wish you luck. If you need to chat, email me. Leslie Lee

HI TERRI, I FINALLY GET TO SEE WHO YOU ARE. I HOPE EVERYTHING WORKS OUT FOR YOU. I HATE YOU'RE HAVING SUCH A HARD TIME. I'LL KEEP MY FINGERS CROSSED FOR YOU. MELANIE

Hiya Melanie! I hope things are going easier....everything paperwise is in the hands of my insurance. I had it out last week with my PCP and his lack of documentation. So much so...he went thru my paperwork concerning the 6 month diet and did a detailed history of all the visits and made all kinds of notes concerning my diet and exercise program....had his PA fax it all in to the insurance case worker and then called me and told me that everything was taken care of! So..sometimes you just have to stay on them it seems. I'm just sitting and playing the waiting game! Nervous as ever. I'm glad that you have kept me in your thoughts! Terri