Aetna...3month and 6month concurrent?

[lexysmommy 0]

Has anyone tried to do both of the requirements concurrently? I really want to give the 3 month a shot but am so worried that it will be denied like the others at my clinic. I asked them yesterday if I could do them both at the same time. They said they'd get back to me today.

[faithmd 14]

I'm not sure what you mean by the 3 month *and* the 6 month. I have read on here (use the search function and put in Aetna) that Aetna rarely approves for the three month supervised diet. But I am by no means an expert.

If Aetna's diet requirements are *either* three or six months, then you would be doing it concurrently by doing it at all. I will caution you NOT to stop visiting your doctor after completing three months thinking they'll approve you with that. Keep going monthly while waiting for their approval. If they deny you and you've stopped going monthly while waiting for their answer, then you'll have to start all over again.

Hope this helps

[lexysmommy 0]

The 3 month program and the 6 month program are not the same, they have different requirements, so if you choose one and don't get approved you have to start over.

They just called and I can only do one or the other. I chose the 3 month plan, so keeping my fingers crossed that it works.

[faithmd 14]

Wishing you the best of luck! You might want to go check out the Yahoo group: bandstersinsurance There is a lot of information there as well.

[passiton 0]

Atena denied my claim just yeaterday. I completed all the requirements, 6 month supervised weight control, Dr recommondation letter, 5 year history of obisity, pys. evaluation, etc. . . . But my BMI droped to 38 and they require at least 40. I plan to appeal, but is there really any hope?

[RKidder 0]

Aetna denied me based on missing 5 consecutive years of documented weights. Why didn't they just request this info and give me an opportunity to provide them with this info before jumping the gun to deny my claim? I had my old PCP's office send an office note dated in 1998 that documents my newly diagnosed Diabetes and a documented weight going back 9 years. Now the appeals process will take 45 days. That means scheduling my surgery date a 3rd time. My boss is going to have a kitten when she has to change the dates my leave yet again. I am convinced that insurance companies are trying to discourage patients into giving up!

Rachel

[faithmd 14]

It stinks that they don't contat you before denials if there is info you needed to provide, but I have always, and will continue to stress the absolute importance of contacting your insurance company before starting this process and requesting the qualification criteria for approval. Then make sure you get a copy of it so you have it in writing. If you had known they required the 5 years, I'm sure you would have submitted that information in the first go-round.

Of course there are the companies that change their requirements mid-process. But if you have it in writing from when you started, they will usually cave and grandfather you in to the old criteria.

[AnnaB6 1]

OMG! you have me so scared because I have everything ready to be submitted except one year. I have sleep apnea, a bmi over 50 and four years out of five. In 2004 I lost my mother and I was a terrible wreck and was not seen by anyone. I went to curves but that was about it. Oh by the way I also have Atena pos