Question:
Aetna requires 6 month of supervised exercise..what did the others of you do?

I thought going to the Y was enough but it isnt..HELP    — Kathy S. (posted on May 16, 2003)

May 16, 2003
Can you have a Personal Trainer there 'document' monthly visits to discuss your progress? If so, do it, then take it to your PCP and have it included in your medical record. If possible, have your PCP reference the PT notes.
   — [Deactivated Member]

May 16, 2003
Aetna actually requires 6 months of DOCTOR supervised dieting and exercise. You need to check your doctor's records and start documenting this with your doctor. They will not budge on this, so make sure it is in your medical files.
   — Jane S.

May 16, 2003
NOT ONLY DOES IT HAVE TO BE DOCTOR SUPERVISED BUT THEY WANT CONSULTATIONS WITH A DIETITIAN ALSO. BE SURE YOUR PCP MAKES EXTENSIVE NOTES IN YOUR RECORDS. IF THEY DONT FEEL YOUR DOCTORS NOTES ARE CLEAR ENOUGHT, THEY WILL CONSIDER THAT NOT ENOUGHT DOCUMENTATION & THEY WILL WANT YOU TO START THE 6 MONTHS ALL OVER AGAIN. ON MY 2ND APPEAL I ACTUALLY HAD TO HIGHLIGHT THE SECTION OF NOTES FOR EACH VISIT THAT WERE ABOUT WEIGHT LOSS, EXPERSIZE & DIET.
   — PATRICIA S.

May 16, 2003
My diet and exercise was NOT supervised by my PCP. I checked in with a Nurse unrelated to the PCP. She took monthly notes on my diet and exercise, which were included in My PCP's records.
   — [Deactivated Member]

May 16, 2003
I just went thru all of this with Aetna. I had surgery 3 weeks ago & I have lost 27 lbs! First of all,my PCP noted in her remarks that I had been exercising & listed what kind of exercise I had been doing that month along with my food plan. I also went to aerobics for over 1 year & had the instructor write me a note, on professional letterhead, stating that. Ask your PCP to keep excellant records for you. They will want to see your weight for each of those 6 months, too. As far as the dietician went, she wrote that she was very qualified to put me on a reducing diet & so did the aerobics instructor. I had a battle with Aetna, I crossed every T & dotted every I. You may find my profile well worth reading, as I documented everything there.
   — [Deactivated Member]

May 17, 2003
i also was denied by Aetna ppo for the same reason, i'm now going to a dietician who says she will give me the letter and info i need to qualify , (she believes in the surgery) but now i'm nevous about what info the insurance requires. is it a matter of proof that dieting and exercise doesn't work permanently or that i can go on a diet and exercise? they said they want detailed records but i feel so unsure about what they want.
   — sharmimi

May 17, 2003
Hello!!! I have Aetna PPO and was just approved even though I did no thave two years of medically supervised diet and excercise. In my case what I had was three months on a doctor prescibed weight loss medication, It was addictive so my dr. only allowed me to be on it for threee months. They sent in a letter stating this and I also called and talked to my case worker (i think that helped a little) Also I believe weight watchers and anywhere else that you go where you got weighed in , you could get your records from may help. Good Luck!!!!!!
   — Dana G.

May 19, 2003
I was denied by Aetna one month ago because of the 6 month diet and exercise clause. Even though I had a letter from my PCP indicating that I had on a 6 month diet and exercise regimen. It was not indicated in my PCP's notes, therefore, not acceptable to Aetna. Even though you could see my weight decreasing in the Doctor's notes. I have gone back to my PCP and explained the criteria. I will be seeing him once per month especially to get weighed and to document how it's going with the diet and exercise regimen.
   — Susan F.

May 19, 2003
I was also denied by Aetna and have appealed. When I spoke with someone in the appeals dept., they actually held my appeal information until my 26 weeks on Weight Watchers was up and I faxed that to them. I should hear this week whether that was good enough. Keep in mind though, that my PCP was documenting my attendance at WW as well as my dietician consultations and exercise regimen (trainer at the local Y). Good Luck.
   — Carolyn M.

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