Question:
Has anyone had to appeal aetna ppo, because of no recent diet history
My wife WAS RECENTLY DENIED SURGERY, from aetna saying she doesnt have any history in the last two years, but prior to this she has 4-5 years of medically supervised history. who has to write the appeal her or the doctor,and does any one have a copy of a letter we could see. — Barry Q. (posted on October 24, 2002)
October 25, 2002
I was approved my Aetna POS 1 1/2 months ago without physician supervised
diets. But I had a huge list of diets I had done on my own including
recent ones. Has your wife tried to diet at all on her own in the last 2
years? If so, list those! One important thing to include is any weight
fluctuations that show up on your medical info. Like if you were dieting
on your own, you can get your weight off your medical chart and show how it
went up and down over that period of time. That helps document what you
were doing.
— ediecat
October 25, 2002
http://www.obesityhelp.com/morbidobesity/m-instrouble.phtml
This is the letter you are looking for. Hope everything goes ok for you.
— Lana Rush
October 26, 2002
Also, if your wife has done a diet program such as Weight Watchers or LA
Weight Loss she can contact them for their records and submit that
information as part of her diet history. I would also immediately go to
your PCP and get started on a supervised "diet program." By the
time you file your appeal and get the paperwork done if you are denied
again, you will have the supervised diet history and can resubmit for
approval.
— Ellen M.
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