Aetna Question

[Yellowdaisy1979 0]

Hello all! I have a question. Hopefully I can make it understandable.I've tried talking to Aetna but they dont understand what I'm trying to say...aaaahhhhH!!! LOL!

First, I am doing the 3 month plan with Aetna. Aetna Choice POS II. I have a BMI of 40 plus 2 comorbities. I have to do the doctor visits with the 3 months of diets and exercise plan.

I started going to my PCP doctor in June will his approval of the Lapband. So, I had my initial doctors appointment June 6.

I didn't see my trainer for the exercise piece till the end of June. So my exercise plan is a whole month behind my PCP visits! This is the complication part for me to figure out.

Sooo....this is the question. Do I have to have 12 weeks TOTAL of exercise visits or will 8 weeks of exercise do with the trainer to be on track with my doctors visits? Anyone been through this? I don't know if they will recognize the 1st visit and thereafter as the start whether or not I started the trainer piece late.

I want to be on track but I'll have to do the extra months with my PCP to get in track with the exercise/trainer piece. Of course, I'm trying to go through this process quickly but I cannot get straight answers!

Hope this make sense....hopefully! Thank you!!!!

[PatchIP 8]

I only had to have one visit with the trainer & I did the Aetna 3 month plan. My dietician documented my exercise in her notes, so maybe that counted but I only needed one visit to meet the requirements for the trainer.

[PatchIP 8]

I only had to have one visit with the trainer & I did the Aetna 3 month plan. My dietician documented my exercise in her notes, so maybe that counted but I only needed one visit to meet the requirements for the trainer.

[Yellowdaisy1979 0]

Wow! Wonderful! I see my PCP monthly and he is recording my info also! Good! I hope mine is the same way. I meet with my trainer atleast once a week and then continue with things on my own. But I'm paying $60.00 extra dollars a month just for a trainer to have the documentation in my file. I guess I can see how it turns out. Thank you so much for your help.

The coordinator stated I wouldn't see a dietician or psych eval till I completed the 3 months course first. Of course, all places are different. In the process of scheduling my sleep study b/c he stated I may be able to go through the process more quickly if I already have that completed.

I'm so excited but nervous. I dream about it constantly and it's making my sleep horrible!! LOL!

I really appreciate you taking the time to let me know......good luck on your journey!!!

[PatchIP 8]

Hmm, goes to show how each place is different. I had my psych eval first, then first nutrition eval, then EGD, etc. I didn't need a sleep study.

One word of advice - Aetna started to demand additional information at the last minute. Fortunately, I was able to get my PCP's office to fax it in time for my surgery but it was only 1 or 2 days before my date that I got approval.

[Maddysgram 6,159]

I also have Aetna Choice PosII, I have to see PCP for 6mos.(1visit left), attend nutritional 6hr class, get physc eval, meet with dietitian. Exercise was included with PCP visits. Bariatric center said they usually have ok within 2wks. I hope and pray!

[Yellowdaisy1979 0]

Thanks to the both of you. Yep. The first thing I had to do was go to an information meeting that is required by the hospital before you do anything. They also give you the paperwork up front to fill out. Then I'm on my own with the PCP visits and the exercise part. THEN I call the bariatric center back and they schedule everything from then on! They will schedule it all. I guess it's a good thing but it is confusing when so many places do it different. I'm excited though. Sometimes I cannot sleep waiting for this process.

Thank you for your advise! Glad to see so many supportive people here!!!

[shel624 8]

I also have Aetna Choice POS II. My first appointment was in July and did not meet with the nutrientist until my second visit in August, within that time I had gained weight. Now I am in a panic that I will not be approved by Aetna. My last appointment is October 10th and then my papers get submitted. I was not advised to see a trainer outside of the normal office visits. However I already did the physc evaulation but the sleep study was denied. I can't stop thinking about this, it is driving me

nuts!!

Good luck everyone!

[Maddysgram 6,159]

I also have Aetna Choice PosII' date=' I have to see PCP for 6mos.(1visit left), attend nutritional 6hr class, get physc eval, meet with dietitian. Exercise was included with PCP visits. Bariatric center said they usually have ok within 2wks. I hope and pray![/quote']

Update... Aetna approve 1 wk to the day papers sent in. Oct 15 date!!!

[shel624 8]

Congrats Maddysgram!!!! So happy for you.

[Maddysgram 6,159]

I also have Aetna Choice POS II. My first appointment was in July and did not meet with the nutrientist until my second visit in August' date=' within that time I had gained weight. Now I am in a panic that I will not be approved by Aetna. My last appointment is October 10th and then my papers get submitted. I was not advised to see a trainer outside of the normal office visits. However I already did the physc evaulation but the sleep study was denied. I can't stop thinking about this, it is driving me

nuts!!

Good luck everyone![/quote']

I can relate. That's why I started hanging out here. Learn all you can while waiting.

Dr also said I had sleep apnea, but I didn't have to have sleep study.

Stick around here & best wishes!