Question:
I cannot find on the site a good PCP letter for Aetna Us Healthcare

As I posted yesterday my PCP's letter just isn't god enough I was told by my surgeon, it was 1 short paragraph. I have tried searching this website to find one but can't seem to find a sample. Would anyone be able to e-mail me a sample of one that worked for you, if you have Aetna US Healthcare all the better. I have to call my PCP today aand let him know he needs to re-write it and I'm afraid, I know he's busy, and I think he's getting tired of hearing my name. Your help would be greatly appreciated. Thanks [email protected]    — jane O. (posted on April 25, 2003)

April 25, 2003
Aetna does not require a letter from your PCP. It requires documentation from the medial record for 6 months diet/exercise program and 5 years Morbid Obesity. Here are their current requirement (as of 17 Jan 2003): www.aetnaushc.com/cpb/data/CPBA0157.html
   — [Deactivated Member]

April 25, 2003
As the previous poster stated, a letter from your PCP is not what Aetna is looking for. They want to see your medical records where it indicates that you have been on a physician supervised diet/exercise regimen for 6 months out of the past 2 years. They also want documentation where you have seen a dietician/nutritionist. This documentation is required and a letter from the PCP simply stating that you have been on a diet is not sufficient anymore (prior to 1/1/03 that would have been enough). I am in the same situation as I also have Aetna. I also have a WLS friendly PCP who is doing everything he can for me documentation wise. I don't know if anybody has fought these requirements and won (this year) or not, but by the time that would happen if it's even possible, you could have the required 6 month diet/exercise/dietician thing done and over with. Good Luck
   — Carolyn M.

April 25, 2003
I have Independent Health, Not Aetna, and am wondering if there is a source for sample PCP letters, because that IS what I need, and the doctor I'm seeing now has no experience in WLS. I'd like a good sample to show him THanks
   — Kelly B.

April 25, 2003
I had on open RNY under Aetna US Healthcare MC on 05/07/02. The "letter" I got from my PCP was handwritten on the script pad that he uses to write medicine prescriptions and simply said "I recommend bariatric surgery for this patient due to her inability to control her weight through exercise due to multiple orthopedic problems." It was as simple as that and I had no problems with approval.
   — Kelly S.