Almost time to submit to Aetna

[tamlalynn 13]

Hi Everyone - I have a lap band and it has not worked out for me so my goal is to have the band removed and get the sleeve. I've been cleared by cardiology, pulmonary, psychology and am going to my second nutrition session next week. I have Aetna who requires 3 sessions with registered dietician within a 90 day period. I have not lost weight during the first month. Slightly concerned that Aetna will deny. My surgeon's office will submit the request after the last nutrition session. Has anyone been in a similar situation that lead to denial?

[Amayor85 19]

I have Aetna am in NYC it's been a week and a half and I still haven't heard from them ! Am a lil worried maybe it's just a nyc delay am not sure am just worried

[Sajijoma 1,324]

The wording from Aetna is that there cannot be a net gain. As long as you haven't gained any weight, it's fine that you haven't lost, as long as you've been compliant with your 90 day program. I know the waiting is nerve wracking, but maybe you should just call and see the status of things. I called twice to find out my status and I'm glad I did! The first time I found out my stuff hadn't been submitted because the psych held my eval hostage because he forgot to Bill me. Then it took another week to get the recommendation letter from the surgeon because he was out of town in that time, so when they did get it all submitted, I called Aetna again and they told me it was being assessed. Later that afternoon it was approved. It never hurts to call. In some ways the squeaky wheel gets heard in this business.

[tamlalynn 13]

My 1st visit with the NUT 233lbs, 2nd visit 235, 3rd visit 233. My last session with the NUT is 3/8. I intend to replace 2 meals per day with Protein shakes to ensure I have sufficient weight loss. My NUT is great. I have so much education about success post op. I don't want to get denied. Has anyone had similar situation preop?

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[1excited 15]

My 1st visit with the NUT 233lbs, 2nd visit 235, 3rd visit 233. My last session with the NUT is 3/8. I intend to replace 2 meals per day with Protein shakes to ensure I have sufficient weight loss. My NUT is great. I have so much education about success post op. I don't want to get denied. Has anyone had similar situation preop?

Sent from my SM-T230NU using the BariatricPal App

Your plan should mention something about weight gain. My plan required an exercise program with documentation.

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[Mary2016 55]

I have Aetna and am in the process. I have my 3rd check-in next week(2 months on a nut program). I asked my surgeons office about the exercise and they said the nutritionist will document it. I have to admit I ate a lot before my first visit so I would have some leeway when I had to lose weight. I lost 2 or 3 lbs. the first check-in. In the past couple of weeks I have buckled down and gotten serious with tracking, exercise, Water, etc. but I retain water sooooo easily. Even in the past, losing weight with weight watchers, I would be so on the program and would bounce up and down. I went to the Vitamin Shoppe and bought some sample Protein packet for Protein Shakes. Dependent on what my scale looks like on Tuesday and weds, I may start them and cut down on the food/ carbs for my Thursday nut check-in. I hate playing this game and it causes so much stress.

[1excited 15]

I have Aetna and am in the process. I have my 3rd check-in next week(2 months on a nut program). I asked my surgeons office about the exercise and they said the nutritionist will document it. I have to admit I ate a lot before my first visit so I would have some leeway when I had to lose weight. I lost 2 or 3 lbs. the first check-in. In the past couple of weeks I have buckled down and gotten serious with tracking, exercise, Water, etc. but I retain Water sooooo easily. Even in the past, losing weight with weight watchers, I would be so on the program and would bounce up and down. I went to the Vitamin Shoppe and bought some sample Protein packet for Protein shakes. Dependent on what my scale looks like on Tuesday and weds, I may start them and cut down on the food/ carbs for my Thursday nut check-in. I hate playing this game and it causes so much stress.

My NUT documented what I told her I was doing but I also had to turn in proof that I was actually doing it. My surgeon's office sends everyone to the cardiac clinic but I felt out of place sp I did it through my gym (made it more fun). I got my Aetna approval on Friday and i am super excited. Try not to let it stress you....I HATE the scale!!!

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[tamlalynn 13]

My 1st visit with the NUT 233lbs, 2nd visit 235, 3rd visit 233. My last session with the NUT is 3/8. I intend to replace 2 meals per day with Protein shakes to ensure I have sufficient weight loss. My NUT is great. I have so much education about success post op. I don't want to get denied. Has anyone had similar situation preop?

Sent from my SM-T230NU using the BariatricPal App

Your plan should mention something about weight gain. My plan required an exercise program with documentation.

Sent from my SM-G530T using the BariatricPal App

Guideline says "there should be no net weight gain". I hope that means over the entire 90 day process. It's not that specific so I am keeping my fingers crossed and was wondering if anyone else had experienced any issues.

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[kimkw 7]

I have Aetna and am in the process. I have my 3rd check-in next week(2 months on a nut program). I asked my surgeons office about the exercise and they said the nutritionist will document it. I have to admit I ate a lot before my first visit so I would have some leeway when I had to lose weight. I lost 2 or 3 lbs. the first check-in. In the past couple of weeks I have buckled down and gotten serious with tracking, exercise, Water, etc. but I retain Water sooooo easily. Even in the past, losing weight with weight watchers, I would be so on the program and would bounce up and down. I went to the Vitamin Shoppe and bought some sample Protein packet for Protein shakes. Dependent on what my scale looks like on Tuesday and weds, I may start them and cut down on the food/ carbs for my Thursday nut check-in. I hate playing this game and it causes so much stress.

I have used powders?utm_source=BariatricPal&utm_medium=Affiliate&utm_campaign=CommentLink" target="_ad" data-id="1" >unjury products alot over my 4 years with a band. The vanilla is great with something orange like orange tangerine mio

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