Question:
After submitting 5 yr. records & Dr. diets, Aetna is asking for

my recorded weight in the year 2000 (I knew this was the one year I had sketchy details!! I have weight and receords for all the other years. In 2000 I only had some telephone consults with my OB-GYNs office for med. refills but NO office weigh-ins!) Sure enough, they're asking for my weight for that one year! I have racked my brain thinking of anything - even called the Red Cross where I gave blood in 2000, but they said they didn't record donors weights. My surgeon's office girl says Weight Watchers will NOT suffice (she seemed pretty certain on this). DOES ANYONE have any suggestions?? One other question, in addition to the weight in 2000, they're requiring a psychiatric evaluation before making a decision (I assume because I've been on anti-depressants for several years). My husband feels they wouldn't be asking me to get this evaluation done "up front" unless they were leaning towards approving me. What's your opinion? As always - THANKS so much for your responses. The people on this board have been my life line! Carly    — Carly H. (posted on October 16, 2003)

October 16, 2003
Carly, please read my profile.... It should help you, alot... Karen Corkran is my name. If, you have nothing else stating your documented weight during that year, & you do have documentation for the other years, SEND IN THE W. W. STUFF!!! I think that will be fine. The psyh evaluation is something that they require for us. It will be ok. Just cross every T & dot every I! Send them everything that they ask for plus a few extra things. I got my surgery less then 6 months ago & I am down -75 pounds. Good luck & feel free to e-mail me...
   — [Deactivated Member]

October 16, 2003
I think a psych eval is pretty routine for this type of surgery. My doc's office requires ALL patients to have one as a part of the entire process. It was a piece of cake. But, i'll admit I was nervous before I had mine too. I also have Aetna. I only had 4 of the required 5 years of physician supervised diets/weight loss attempts. I made a list of every rediculous fad diet that I had ever been on (they wanted those too). Finally, I wrote a personal letter to the person reviewing/approving my surgery. I wanted to make sure they knew that there was a real living breathing person attached to that "file number" in their in-basket. I can't be sure, but I think it swung things in my favor. I filed for approval almost 8 weeks prior. They approved me within days of receiving my letter. I could be wrong, but I dont believe I am. You can have a copy if you like. Let me know. Good Luck!
   — Babs B.

October 16, 2003
I'm no expert at all but maybe you could send MORE than the years they're asking for to show that you've been a stable "heavyweight" long term and that you aren't trying to hide anything in 2000 and then also include the WW stuff so that even if its not official it'll provide continuity. I wouldn't put too much stock in the psych eval thing. Even my PS does a psych eval of all his patients.
   — Shelly S.

October 16, 2003
I am still waiting for approval from Aetna too, so I'm not sure how much help I'll be. I sent 10 yrs of pcp medical history, A personal letter of 10 pages, a co-morb list, a family history, and pictures. The letter, co-morb list, and family history info I got off of Sharon Brittains profile. She has helped 100's of people get approved and I KNOW I will get approved very soon. She does not mind sharing her info, and you can tailor your letter ect.... using her info as a guide. I would send in this additional info. I don't think being on anti-depressants will hurt you at all in getting approved. I think mostly ALL MO people have been depressed (including myself) whether they ever took meds or not (I didn't). I also thought of omething else. Maybe you can look under the professionals listing at the side of this site (when you 1st pull up web site) and find reviews of psych'c in your area so you can find one that has had GOOD REVIEWS. That's how I knew which one to go to in my area. Hope this has been of some help. Good Luck! I KNOW YOU"LL BE ON THE LOSING SIDE SOON!!
   — bufordslipstick

October 16, 2003
I would not worry about the psy e-vail. My surgeons office said they would not have me do it until i was approved, they did not see the point. I'm on the waiting side also, waiting with everyone else. My stomach is turning inside waiting! They came back and said they needed a break down of codes, one of my diet doctors used codes on the form and whoever was reviewing it did not understand what they were. Well that was sent and now I am waiting. I thought that since this is all they asked for maybe thats all they need. Well I pray this is true. I wish everyone luck.
   — Melissa B.

October 16, 2003
Aetna is now requiring a psych eval before they will even consider approval. You can see their requirements at http://www.aetna.com/cpb/data/CPBA0157.html I was also missing one year of documented weight, however, I (like a previous poster suggested) was able to go back several years prior to my missing year (1999) and show that I was morbidly obese for more than 5 years. I believe my records that I sent them went back to 1995. Also, Weight Watchers was my 6 month physician supervised diet. My PCP was aware of my WW attendance and noted it in his records and I also went to his office monthly to get weighed in and that was accepted by Aetna. So, even if your surgeons office says that Aetna won't accept WW weigh-ins as proof of weight, it doesn't hurt to use it if you have WW attendance records and weigh-ins. I was initially denied by Aetna because I didn't have the 6 month physician supervised diet, however, when I appealed, they didn't process it through (and more than likely deny me again) until I was able to fax them my Weight Watchers weigh-in on my week 26 (6 month) attendance. I was then approved within 10 days.
   — Carolyn M.