ocbreeze4u

I knew about the 2 years of a high BMI and I did not have to do a psych evaluation but I also did not need to have a pre-diet. Other than the two appeals regarding my BMI dropping below 35 BMI in the last year (it only dropped .04% to 34.6 BMI) and I was below by only ONE POUND, I did not have to "jump through hoop" as I have heard from some. Maybe it depends on the nurse reviewing each individual case at Aetna or maybe it was because I was already on a Doctor supervied diet at the time my case was submitted to Aetna? Well, at least this comfirms what I have always known that Aetna is NEVER consistant and you just need to know who to brown nose over there to get what you want:sneaky: LOL

I would really like to help you with your problem but I need more information such as what is your BMI? Do you have any health problems?

Hello all July 2008 members! My name is Dawn and I got my date this morning for July 24, 2008 for my Lap Band surgery with Dr. Naim of Top Surgeons in Southern California. I am currently 222 lbs and my goal is a glorious 125...I have 97 lbs. to lose. My journey to this point has been long as my case was originally submitted to Aetna back in January and after two appeals I was approved last week. I hope to get to know all of you and we can help each other get through this.

Anyone on here using Dr. Naim of Top Surgeons in Beverly Hills/West Hills Ca? I went to Dr. Michael Omidi there for my Rhinoplasty and Septoplasy and I was very impressed but I would like to hear from those using Dr. Naim for Lap Band. Sincerely, Dawn - 39 years old Corona, CA Aetna approved for Lap Band 06/11/2008 And waiting for surgery date "] [/url]

I have not got my lap band yet however, I am a Nurse Practitioner and would definately do it after a trained professional showed me. It would save be trips to Beverly Hills and some money to boot :sad_smile:

If you are rataining fluids, keep your sodium intake below 1800 mg (anything above 2500 is very bad) for two days and drink at least 64 oz of water daily. Your body should level out after two days.

Hello Man of the Sea! Having faith in Dr. Naim is no question in my mind as Dr. Naim works for my other surgeon Dr. Michael Omidi. It sounds like you went to the other group of surgeons that Dr. Naim works with. I am with going to have my surgery done with Top Sugeons, Inc. in Beverly Hills and my surgery will be done at their surgery center in West Hills. Their office staff is great there too. How are you doing right now? How was your first few days after surgery...please share your story.

I've got one that I truly will not miss... Not being able to shave "down there" and missing spots due to I cannot see past my stomach not matter what position I am in...lol ! It is hard to do just by touch and I have cut myself a few times.

Hello! My name is Dawn, 39 years old and I live in sunny Southern California. After initially seeing the doctor for Lapband in January 2008 then going through 2 appeals I FINALLY received news yesterday via mail that Aetna over turned their decision and granted me the approval for Lapband with Dr. Naim. They will be setting my appointment on Monday for sometime in late July 2008 so I am very excited. I am currently 222 lbs. with a BMI of 37 and my goal weight is 125...no, I am not being unreasonable as I was 125 8 years ago when I was 31 so this is not a high school weight I am throwing out there:wink2: I wish all of you luck and I would also like to know of others that live here in California to do some online bonding with. Dawn Corona, CA height 5' 5" current weight 222 goal weight 125 Currently approved by Aetna and waiting to schedule surger for July 2008 with Dr. Naim with Top Surgeons in Beverly Hills, CA

Lisa, please read your email...I sent you a private message.

Welcome to the group! I would like to recommend the medical group I am in. They are called Top Surgeons and the doctor is Dr. Joseph Naim that actually does the Lap Band Surgeries. I have had some cosmetic proceedures done with this office with Dr. Michael and Julian Omidi. They are very nice and efficient. Their main office is in Beverly Hills and that is where the seminar is however the surgery is done in West Hills. I am in the health care industry and what impresses me the most about them are when you call the doctor for any help or questions, the doctor actually calls you back and not a nurse or a member of the office staff. The also offer 100% financing at 0% interest for those needing it. The website for Top Surgeons is weight loss Los Angeles lap band Beverly Hills Los Angeles lap band and Dr. Joseph Naim is Los Angeles LA Weight Loss Bariatric Center Dr. H. Joseph Naim M.D., F.A.C.S. Good luck on your journey, Sincerely, Dawn - 39 years old Corona, CA Aetna approved for Lap Band 06/11/2008 And waiting for surgery date

Hi again Tracy! I think self pay is worth it as it has taken me 6 months and two appeals to get approval. At one point I was willing to max out credit cards at a high interest rate or do 100% financing with my doctor's office but my doctor insisted that I be patient and just wait to see if the second/final appeal went through...it was approved. I am curious....I know in Canada everyone has access to a national health care plan. Do they cover any Gastric Surgeries under any approved circumstances or is it not covered at all? If it is covered then what is the criteria? Sincerely, Dawn - 39 years old Corona, CA Aetna approved for Lap Band 06/11/2008 And waiting for surgery date

I have Aetna PPO Choice (not HMO) with a BMI of 37, one year ago I did drop to 34 BMI hense I was initially denied. After 6 months and 2 appeals I was finally approved and I got the letter from the insurance company last Friday. I am slightly diabetic but that is it. You did not mention who your insurance carrier was...just curious? Good Luck! Dawn - 39 years old Corona, CA Aetna approved for Lap Band 06/11/2008 And waiting for surgery date

The reasons I was denied by Aetna... Aetna's criteria is that you must have a BMI of at least 35> persistant for the last two years. About a year ago my weight went down to 204 which lowered my BMI to 34.7...if I were just one pound more at 205 I would have been at 35 BMI. I missed it by one pound! The second time Aetna denied me was due to my doctor then entered my height as 5' 7" weighing 222 lbs, I am 5'5 so again...in the last two years my BMI dropped below 35 lbs. In both cases my doctor did a peer to peer review with Aetna and in the end he prevailed and I won!!! Just for the record, I am with Aetna PPO Choice. I do know that Aetna HMO does not cover this surgery. Thank you to all of you for your kind words of encouragement. Dawn

I originally went to them for Lap-Band and while fighting with my insurance with several appeals I had Dr. Michael Omidi of Top Surgeons do my Rhinoplasty and Septoplasty (nose job). They are beyond understanding and kind there. Dr. Jullian Omidi (he prefers Dr. Jullian) is awesome that he is the one that will do your work up for your insurance. Dr. Naim is the doctor that actually does the Lap-Band Surgery...Google him and you will see that he has a very impressive resume when it comes to Gastric Surgeries. Ironically I finally got my approval today from Aetna after 2 appeals over a 6 month period. My only advise is his office staff, they are very kind and considerate however, if you go not keep on them they tend to procrastinate. Just make many follow up phone calls and you will get exactly what you want and need and if all else fails, call Dr. Jullian and he will put the fire under the office staff :rolleyes2: If you need more information then let me know as my surgery will probably be scheduled in two weeks. Dawn P.S. My nose job was absolutely BEAUTIFUL!!!