what type of documentation from your doctor?

suez383 · August 3, 2011

Ok, so I am just about done with my 6 month supervised diet plan. My surgery is scheduled for Sept 19 and my last check in with my PCP to complete my 6months is August 30. I stopped in there yesterday to ask them to fax over everything for the last 6months to my surgeon. I saw that they were just sending the progress notes, and honestly there wasn't a whole lot written on it. I asked to look at the one, and it had my identifying info on the top with my weight and height, puls/ BP etc...Then my doctor wrote pt is obese and is trying to lose weight. Pt is following an 1800 calorie diet, pt is trying to exercise more and a couple of other comments. That's about it. I am worried about getting denied for not enough documentation. I mean is that enough?

Also, reading on Aetna's website it also says I have to be in some sort of exercise plan. Um, I have been working out at home on my own, but I don't have a gym membership or anything. My husband has been out of work since May, and it was another expense that we just can't afford. My surgeon didn't tell me anything about it, so I am worried I went through all of this for nothing.

Any advice would be greatly appreciated cuz I am freaking out right now! Thanks!

wondering1 · August 3, 2011

Suez,

I know all Aetna plans can be different by my Aetna *** has been pretty good about what they will accept. Working out at home has been fine for me. Also, I don't think they need detailed notes from your pcp, just documentation that you are trying and they are recording your weight. Aetna didn't even require me to lose any weight before approval. I am surprised you had to do 6 months though. My Aetna *** only required 3 months. And usually, the surgeon's office has someone there that deals with the insurance companies. These individuals know exactly how to get everything approved so the surgery can go forward. If you have specific questions though, call Aetna and speak to a representative about your plan.

Hope this helps and good luck!