Question:
can i get documentation?
Hi i am waiting for my surgeon to send my aperowrk to aetna for approval and i get a cal today from his nurse and she told me that i need my weight watchers proof of membership for 90 days...well i dont have it anymore. i called the local number and this mean woman says they dont keep records. i am stumped. the nurse said she gets a letters from weight watchers all the time for patients...i live in dallas so if anyone can help me a little i would greatly appreciate it. — mellybelly1973 (posted on December 23, 2003)
December 28, 2003
I have Aetna too, and recently got approved after appeal. As per Aetnas web
site, you can send in for pre-approval prior to the 6 mo dieting being up,
but can't have surgery till after 6 mo diet period up. Well, I sent in
after 4 mo, and they req additional doet info. Then I sent in my 5 mo diet
history. They denied.......I finished up 6 month diet and resent EVERYTHING
I HAD SENT PREV ALONG WITH ANOTHER LETTER FROM PCP, APPEAL LETTER FROM
SURGEON, APPEAL LETTER I HAD WRITTEN, AND DUMMIED DOWN ALL INFO SO THEY
COULD READ QUICKLY AND EASILY. The main reason I am answerting this is that
you don't need diet history from W.W. I had been to them twice and the
surgeons office had wanted to send in this info for MY appeal also. In Ky,
W.W. will not give you any documentation stating you've went there either,
and I couldn't find my wkly sign in papers. (Funny, how they -W.W.- don't
mind taking our $$ but DO mind giving us documentation stating we've went
there previously.)ANYWAY I COLOR CODED ALL WEIGHT in medical records from
past 10 yrs, THE 6 MONTH DIET I HAD JUST BEEN ON, MY DIET HISTORY starting
from when I was in my early teens, the PSYCH LETTER, the DIETICIAN LETTER,
and made a cover sheet showing what colors were for each topic. Then I took
different colored sheets of paper and put in between all topics in appeal
(letters from Drs stating I needed this surgery, Psych letter, Dietician
letter, Medical history ect...) AND THEY FINALLY APPROVED ME 12/18/03. Hope
this helps some!! I also sent in a great piece of documentation I got out
of the library that Rona Scott wrote about costs of WLS vs costs of being
morbidly obese ect.... or something to this affect. I really think this
helped in getting me approved also.
— bufordslipstick
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