Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Aetna Sleevers Please Help If You Can, My World May Have Just Crumbled.



Recommended Posts

I'm hysterical right now. I've got my final PCP visit this afternoon so I called my surgeon's office to find out what documentation they needed from her. Day 90 of this 3 month program is November 15th so I want to make sure everything is in order long before then. My last nutrition and psych/behavioral appts are next Monday.

She said the notes from the visits. I asked about the 2 year weight history. I remember reading that I needed documentation that I've been fat for at least 2 years. She said oh yes, notes from 2010 and 2011 also. I said I didn't think there was a note from 2011, but lots from 2010, 2009, 2008, etc.

Nope. They will reject it unless it's the previous 2 years.

Which would mean I couldn't have the surgery until 2014.

And all this hope and planning and appts I've been going to since the end of July are all in in the dust at my feet. I'm so nauseous and dizzy I can barely breathe.

Obviously I need to verify dates at my appt today, but in my gut I know there's no 2011 weight.

I had given up for most of 2010 and all of 2011. I wouldn't even step on a scale.

Share this post


Link to post
Share on other sites

It’s open enrollment time - is there a possibility of changing plans now? Just thinking out of the box and how you can possibly still get what your looking for.

I KNOW I refused to step on the scale often - so I may be in the exact same place as you when my waiting time is up in January. I have to wait six months.

Share this post


Link to post
Share on other sites

Call your insurance company and ask them. Tell them there are detailed notes for the other years, and find out if that's a deal-killer. Also, find out if you can have the surgeon submit it that way, then appeal if it's rejected. Best of luck!

Share this post


Link to post
Share on other sites

Just take a deep breath and try to calm down. I had the similar, although I didnt have your same insurance, It had been over the two year mark since I had seen a nutritionist, but I wrote down everything I had done, in detail, submitted it and they accepted it. All you can do is give them the info and see if they will go for it. Hoping you can get it approved!

Share this post


Link to post
Share on other sites

No other insurance choice for me. Just Aetna. Find out now or you may have to repeat the 6 months. I can't believe I'm just learning this now.

Share this post


Link to post
Share on other sites

Raven......did you have any weight documentation anywhere else? Like from a job pre-screening, curves, weight-watchers.......etc.

Share this post


Link to post
Share on other sites

Have you been to any walkin clinics or emergency rooms in 2011?

Share this post


Link to post
Share on other sites

What about OB-Gyn? Any records there?

Share this post


Link to post
Share on other sites

Talk to your PCP and see what he/she says. Dont panick.

Share this post


Link to post
Share on other sites

I'm hysterical right now. I've got my final PCP visit this afternoon so I called my surgeon's office to find out what documentation they needed from her. Day 90 of this 3 month program is November 15th so I want to make sure everything is in order long before then. My last nutrition and psych/behavioral appts are next Monday.

She said the notes from the visits. I asked about the 2 year weight history. I remember reading that I needed documentation that I've been fat for at least 2 years. She said oh yes' date=' notes from 2010 and 2011 also. I said I didn't think there was a note from 2011, but lots from 2010, 2009, 2008, etc.

Nope. They will reject it unless it's the previous 2 years.

Which would mean I couldn't have the surgery until 2014.

And all this hope and planning and appts I've been going to since the end of July are all in in the dust at my feet. I'm so nauseous and dizzy I can barely breathe.

Obviously I need to verify dates at my appt today, but in my gut I know there's no 2011 weight.

I had given up for most of 2010 and all of 2011. I wouldn't even step on a scale.

[/quote']

I'm sorry please keep us updated. Your dr might be able to help

Share this post


Link to post
Share on other sites

Yes did you use any hospital during 2011? Care now? Prima care? ER or gynocologist? If they weighed you then you can use that.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
    • RacMag  »  bhogue925

      Hi, I’m new here. I’m currently on the liver shrinking diet. So far so good, but I have to say I haven’t found a protein shake I like. Anyone have any suggestions please? My surgery date is September 17th. 
      · 2 replies
      1. BlondePatriotInCDA

        Fairlife Core are by far the best. They taste just as they are - chocolate milk. You can either get the 26 grams or the 42 grams (harder to find and more expensive). For straight protein look at Bulksuppliments.com ..they have really good whey proteins and offer auto ship plus they test for purity. No taste or smell...

      2. BlondePatriotInCDA

        Fairlife has strawberry, vanilla and of course chocolate. No more calories than other protein drinks. Stay away from Premiere, they're dealing with lawsuits due to not being honest about protein content.

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×