Submitted to Insurance, now I wait...

[Miranda Christine 3]

4 hours ago, Jaxs3 said:

Hi new here just had a question for the people with Aetna pos ii plan did the insurance company accept your first weigh in on your consultation appointment or did your 90 day start after that? I had my first appt in February so they are going to try to submit after my May appt.

And how long did they take to approve surgery?

Mine started from my consultation, and as someone said you think it’s just 3 appointments with nutrition but it’s actually 4 if you count the consultation where your weight does count. And you can not gain any weight at ANY weigh in’s or they can kick you out of the program (instant denial) or make you start your 90 days over again. At least that’s how it was for me with Aetna, every weigh in mattered, not just the final. And I was approved within a week, I called Aetna often which is how I found out I was approved, they told me before my surgeons office did. Best of luck!

[Jaxs3 0]

Thanks everyone! I’m nervous they are going to deny me. They wouldn’t approve my echocardiogram but heart doctor approved me for surgery. My BMI is 42 so praying I have no issues. Good luck to everyone

[kimberlymi 113]

For nausea try boiling ginger root or brewing alot of ginger tea bags to make a big quart of full strength ginger tea. Put it in the fridge to save and add a table spoon of into your water bottle. It will take away the nausea fast. I usually take ginger caps when I experience nausea, or motion sickness but I imagine with a tiny stomache, you can only sip Water here and there....You got this!!

You can also rub peppermint essential oil on your stomach, but don’t put it on your surgery spots. I have found it helps a lot and you don’t have to drink it. Good luck. Feel better [emoji854]

[BGrundee 61]

On 4/28/2018 at 1:19 PM, kimberlymi said:

You can also rub peppermint essential oil on your stomach, but don’t put it on your surgery spots. I have found it helps a lot and you don’t have to drink it. Good luck. Feel better

Sorry for the late reply. Im going to try your suggestion!

[michelle0721 13]

I had my finial visit with the Dietitian. She told me that my paperwork will be prepared today and give to Dr. McGill tomorrow for his approval. Once he sign off on my paperwork it will be submitted (by Friday) to Aetna for pre-certification. I'm a little worries because my final Weight 257/BMI is 41.5 with no Co-morbidities. During the 4 month process my weight did fluctuate.

• Feb. 1, 2018 - Weight 261 / BMI 42.21 (Visit with Surgeon Dr. Kevin McGill)
• Feb. 26, 2018 - Weight 261 / BMI 42.21 (1st Dietitian Visit)
• Mar. 22, 2018 - Weight 263 / BMI 42.4 (2nd Dietitian Visit)
• Apr. 23, 2018 - Weight 262 / BMI 42.3 (3rd Dietitian Visit)
• May 29, 2018 - Weight 257 / BMI 41.5 (Final Dietitian Visit)

Does any know if Aetna will deny me because my weight fluctuated during the 90 day Multi-disciplinary surgical preparatory regimen?

[Frustr8 7,886]

By all logic they should not, 2-3 lbs. you might have needed,a bathroom visit before your weighing. Now if you had spiked to,275 or 280 they would have seen it as a red flag. Sending my good thoughts your way. I feel there is a June surgery in your future!😷👍😛

[BGrundee 61]

1 hour ago, michelle0721 said:

I had my finial visit with the Dietitian. She told me that my paperwork will be prepared today and give to Dr. McGill tomorrow for his approval. Once he sign off on my paperwork it will be submitted (by Friday) to Aetna for pre-certification. I'm a little worries because my final Weight 257/BMI is 41.5 with no Co-morbidities. During the 4 month process my weight did fluctuate.

• Feb. 1, 2018 - Weight 261 / BMI 42.21 (Visit with Surgeon Dr. Kevin McGill)
• Feb. 26, 2018 - Weight 261 / BMI 42.21 (1st Dietitian Visit)
• Mar. 22, 2018 - Weight 263 / BMI 42.4 (2nd Dietitian Visit)
• Apr. 23, 2018 - Weight 262 / BMI 42.3 (3rd Dietitian Visit)
• May 29, 2018 - Weight 257 / BMI 41.5 (Final Dietitian Visit)

Does any know if Aetna will deny me because my weight fluctuated during the 90 day Multi-disciplinary surgical preparatory regimen?

I have Aetna. You wont get denied. The first 1st weigh and last weigh in are the only ones that count. You are good to go! FYI I had a major 12 lb increase in weight on my 2nd weigh in and ended up losing it all plus more so by my last weigh in I came in under by 4 lbs from my 1st weigh in. I was approved.

[J San 1,071]

Also have Aetna, my 2nd visit with nutritionist I was plus 1lb. She just told me this today because I am down 13 since then and she was happy. Not sure if way ins with her count though? Or is it just surgeon way ins? Good luck anyway.

@Miranda Christine How did everything turn out for you so far? Hope all went well and you are healing wonderfully!!!

[michelle0721 13]

I called Aetna this afternoon. They said as long as my final weigh in is the same or less than my first weigh in I will get approved.

[J San 1,071]

35 minutes ago, michelle0721 said:

I called Aetna this afternoon. They said as long as my final weigh in is the same or less than my first weigh in I will get approved.

Well there it is, You said it and i'm sticking with it. LOL

Thanx for the info. Good to know.

[Jdesmond73 138]

I’m with Aetna and got denied

[J San 1,071]

1 hour ago, Jdesmond73 said:

I’m with Aetna and got denied

Was there a reason given? I see you had the surgery, congrats on that. Did you wind up getting approved or did you pay for it yourself?

[Jdesmond73 138]

8 hours ago, J San said:

Was there a reason given? I see you had the surgery, congrats on that. Did you wind up getting approved or did you pay for it yourself?

8 hours ago, J San said:

Was there a reason given? I see you had the surgery, congrats on that. Did you wind up getting approved or did you pay for it yourself?

They told me it was not “medically necessary” so I did self pay

[J San 1,071]

51 minutes ago, Jdesmond73 said:

They told me it was not “medically necessary” so I did self pay

That really sucks. What a crap reason. Glad you were able to still go through with it though. Best to you on your weight loss journey!!

[Dee_Rose 6]

@jdesmond73 what was your BMI when you tried to get approved?