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Aetna PPO (Lockheed total fitness)



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Has any of y'all tried to get approve thur Atena? After you completed the 6 month medically superived diet, about how long after that did you get approved for Lap band surgry? I'd like to know what to expect. Thanks! :)

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My wife and I got approved through Aetna PPO. The surgery center that I went through did a 3 Month Multi disciplinary diet. 2 weeks after I finished the diet and it was submitted we were approved. 5 days after approval we were in surgery. That was 10 months ago. I have lost 84 lbs and my wife has lost 67 lbs.

John

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How did you wife get approved after 3 months? Did she lose weight on the diet? Also did she have the Dr. prescribe and weight loss drugs or did she have to go through an exercise plan?

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I went through all the 6 month crap. Had EVERYTHING they asked for. I was denied. They wanted more. I went through excessive expense and lot of time and heartache, but after 11 months. Yes, 11, I got approved. I had to file an appeal but I had my rhuemetologist, my cardiologist, my family physician and my OB/GYN ALL write letters to Aetna in support of this. They couldn't argue with all of them, so I was approved. I had the surgery on 11/19/07. I started the process on January 8th. It was a nightmare but worth it. I still ended up paying my surgeon $3000 because Aetna tried to cheat him out of his fee. His fee is $6,000 and they would only pay $1800. He said he couldn't do it for that. He said if you pay me $3,000, I'll write the rest off and call it even. He knew what I had gone through. WHAT A GUY!!!!

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We did a diet and exercise program through Lindora that counted as the 3 month medically supervised diet. Becasue our BMI was still over 40 we were approved.

John

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I have PPO and am currently going through the 3 month supervised program. My 2nd apt is friday. I have spotty medical documentation for the 5 year history... but severe GERD and apnea. If Im denied I will appeal. Chuggin along......

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