katywv

Thanks everyone! You're giving me hope! I'm just surprised my surgeon's office seems not to have seen this Aetna requirement before. I know it's newish (from last May?) but they're a pretty huge practice and Aetna is not unusual here.

Hi everyone, I had my first visit with my surgeon last week. At first, he said Aetna would require 6 months of sessions. I knew about Aetna's new requirement for 12 sessions so I mentioned that and he had his office check again. He came back telling me that the 12 session requirement means I need to do one session per month for a year. That seems to go against what I've read on here, not to mention the wording of Aetna policy 0157 which says "12 or more sessions over any duration of time". Aetna customer service just tells me to check with my doctor. His office is really insistent that even though the wording of the policy seems to imply that any time period is fine, what Aetna really means is 12 months. Is there any written clarification anywhere that I could take to my surgeon? Otherwise I will be stuck with a 12 month program. Thanks! Edited to change "visits" to "sessions"

Thanks for your response. The word used in the policy is actually "sessions" not visits - I was remembering that incorrectly. Do you think that makes a difference? I will keep trying with Aetna.

Greenchilegoddess were you able to get this sorted out with your surgeon's office? I have Aetna too, but my surgeon is insisting that the policy requires that the 12 sessions have to take place once a month for a total of 12 months! I can't get any help from Aetna. They just tell me to get clarification on the policy from my doctor.