jackiemhornig 0 Posted October 28, 2008 Hi All I have a question and I am waiting for my surgeons office to call me back but figured would see If I could get some answers here.I have Aetna QPOS and the band is covered when precertified so I am going through all the steps required.I had my first appointment with the diet/nutrition center on 9/30 and my second is today 10/28 and my third in on 11/25 - now yes these are 3 appointments one per month for three months, but it does not equal 90 days? Is that going to be a problem when they send in my paper work for the approval process?I am just not sure and want to make sure i am doing everything right? I assumed when I made the appointment it had to be three months back to back not really 90 days?I have my sleep apnea test this saturday night and my appointment with the cardiologist this Friday - then other then the last diet class in november I am done and will have all my requirements met?Anyone with any advise for me on this would be greatly appreciated.Thanks so much. I am still having trouble replying to posts - I can post but for some reason not able to always reply. Share this post Link to post Share on other sites
MacMadame 81 Posted October 29, 2008 It's hard to say. Some insurance companies are buttheads and will pick on every little thing. What did your surgeon's office say? Share this post Link to post Share on other sites
vagabond 0 Posted October 29, 2008 I also have Aetna and I am doing the three month multi-displinary plan. I have my first nutritionist and PCP appointment the first week of August. I have had an appointment with both the nutritionist and PCP the first week of September, October and have plans for Novemeber then my paper work will get submitted. I tried to get exact details from Aetna when I first started the three month. They told me that it was up to my PCP to interpret the rules to qualify for the three month multi-displinary (helpful, huh!). I decided not to take any chances so I decided to do the full 90 days. I hope you have success and get approved. Share this post Link to post Share on other sites
nursekathy2u 0 Posted October 29, 2008 Hi All I have a question and I am waiting for my surgeons office to call me back but figured would see If I could get some answers here.I have Aetna QPOS and the band is covered when precertified so I am going through all the steps required.I had my first appointment with the diet/nutrition center on 9/30 and my second is today 10/28 and my third in on 11/25 - now yes these are 3 appointments one per month for three months, but it does not equal 90 days? Is that going to be a problem when they send in my paper work for the approval process?I am just not sure and want to make sure i am doing everything right? I assumed when I made the appointment it had to be three months back to back not really 90 days?I have my sleep apnea test this saturday night and my appointment with the cardiologist this Friday - then other then the last diet class in november I am done and will have all my requirements met?Anyone with any advise for me on this would be greatly appreciated.Thanks so much. I am still having trouble replying to posts - I can post but for some reason not able to always reply. I do Bariatric surgery insurance approvals for a living. Aetna requires 90 days... an initial visit, then an appointment after 1 month, 2 months and 3 months. So it is actually 4 visits over 90 days. Kathy Share this post Link to post Share on other sites
jackiemhornig 0 Posted October 29, 2008 I do Bariatric surgery insurance approvals for a living. Aetna requires 90 days... an initial visit, then an appointment after 1 month, 2 months and 3 months. So it is actually 4 visits over 90 days. Kathy Thank you so very much for all your help. I can't even imagine what a big help you are on this site.This is what I have scheduled for the nutrionist for Aetna requirements as of today.1st. September 302nd. October 283rd. November 254th December 30If I am correct we figured this is 91 days so I should be ok. Do you think this is ok. I am trying to hard to do everything right to avoid getting denied. Share this post Link to post Share on other sites
nursekathy2u 0 Posted October 30, 2008 Thank you so very much for all your help. I can't even imagine what a big help you are on this site.This is what I have scheduled for the nutrionist for Aetna requirements as of today.1st. September 302nd. October 283rd. November 254th December 30If I am correct we figured this is 91 days so I should be ok. Do you think this is ok. I am trying to hard to do everything right to avoid getting denied. That looks good.. you shouldn't have any problems Good Luck! Kathy Share this post Link to post Share on other sites
vagabond 0 Posted October 30, 2008 Nurse Kathy, thanks for the info, it is really appreciated and now I know that I am on the right track. Do you know if there is a requirment to actually lose a specific amount of weight during this time or any weight? K Share this post Link to post Share on other sites
nursekathy2u 0 Posted October 31, 2008 Nurse Kathy, thanks for the info, it is really appreciated and now I know that I am on the right track. Do you know if there is a requirment to actually lose a specific amount of weight during this time or any weight? K Ideally the purpose of the 3 month progam is to "prepare you for surgery". That would include beginning an exercise routine and dropping some weight. That's what Aetna says the purpose for the 3 month program is. They call it a "Surgical Preparatory Regimen". However, I have never known anyone to be denied for not losing weight. Kathy Share this post Link to post Share on other sites