Final Dietitian Visit

[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?

[allwet 868]

not the fluctuation that will be the deciding factor. Every Insurance company has a policy with the min. BMI and number of comorbidities required with each BMI level. The lower your BMI the more other issues you need to get approval. Don't know Aetna's policy but the weight fluctuations will only an issue if you happen to drop below their cut off BMI.

[michelle0721 13]

Aetna requires a BMI of 40 or more without any co-morbidities.

[RickM 1,747]

Industry standard is 40 BMI or above with no co-morbidities or 35 BMI with co-morbidities (though companies vary about which and how many co-morbidities are required.) Some companies will reserve some procedures for higher BMI's but anything outside of the industry standards are ripe for appeal, both within the company and to state regulators.

I didn't lose anything on Aetna's 6 month diet requirement and that was no problem, though that was seven years ago so policy details may have changed in the interim.

[michelle0721 13]

Got my approval today. Surgery is scheduled for June 19th.

Edited June 5, 2018 by michelle0721

[KristinOlivia 35]

Congrats!!!!

[michelle0721 13]

Thank you