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Aetna- Did not have to do the supervised diet

former_vbg

By former_vbg, in Insurance & Financing

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former_vbg    198

former_vbg
Posted

I just wanted to share my experience with going through the insurance requirements for Aetna that I did NOT have to do the supervised diet. The first surgeon I was supposed to go with- their office just had me submit supporting documentation of the issues I was having from my original surgery 13 years ago. None of the "issues" are life threatening- but rather I was able to demonstrate that the original surgery was a failure. I was diagnosed with Grade C Esophogitus, submitted the weight history, and also had a history of exercise for the 6 months prior which actually was a report from a pedometer I wear and it showed that I regular walk an average of 8,000 to 10,000 steps everyday. I have a small farm by myself and so I get lots of walking in just because it comes with the territory of taking care of everything.

Anyhow, when I had to switch surgeons at the last minute- the new surgeon and even the supposedly experienced person he hires to submit the insurance pre-certs didn't seem to know this was possible. Now, Aetna would not "guide" me on this- but only told me i would have to refer to their policy bulletin online- which I did. Even when I told the new Dr. about this, he seemed to doubt me and I referred him to the fact that I had already received an approval using that approach.

I just think sometimes these people get used to doing things a certain way because it makes their life easier. In some regards I understand that, but if I wouldn't have stood up for myself, they would be having me do a supervised diet for no reason. I doubt anyone having a WLS for the first time could get away with not doing a supervised diet, but for anyone doing a revision- please know it IS possible to not have to do the stupid diet thing. We all know that if we could diet successfully, we wouldn't need the surgery....

Anyone who needs any help for their situation- feel free to PM me and I'll help however I can. I'm not too experienced with appeals- just my disclaimer on that one. I fortunately was approved in about 4 days- no hassle- no fuss.

My surgery date is 6/22

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