needabreak
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I have Aetna PPO and I completed my 6 month physician-supervised visits. Aetna denied me stating that my weight that the surgeon submitted for me for my 2 years for 2008 had a BMI of 39.6 (the visit was for Nov 2008, not exactly 2 years)and it has to be over 40 BMI. My surgeon did the peer-to-peer and they stayed with their decision. So my physician faxed the surgeon my records for a visit I had with her for 05/08/08 which had my BMI at 41, so we faxed our appeal yesterday with the record for 05/08/08 BMI (exactly 2 years). I am stressed out because my surgery is scheduled for May 12th. Does anyone know if I will have a problem with the appeal, since I am sending them proof that I was over 40 BMi exactly 2 years ago, or will the information that my surgeon faxed originaly with the Nov 2008 weight with the BMI of 39.6 hurt me?
Age: 49
Height: 0 feet
Starting Weight:
Weight on Day of Surgery:
Current Weight:
Goal Weight:
Weight Lost:
BMI:
Surgery: LAP-BAND
Surgery Status: Pre Surgery
First Dr. Visit: 01/01/1970
Surgery Date:
Hospital Stay: n/a
Surgery Funding: n/a
Insurance Outcome: n/a