Paperwrk sent to AETNA on 5/12, APPROVED on 5/13!!

[ahb08 0]

OMG yall, i can't believe how quickly i was approved....my case manager submitted on 5/12 at 2pm. and I received a call from Aetna directly at 1pm today that i was approved....!! I was told the approval went so quickly b/c my job...(2nd biggest bank in the U.S.) has reps at aetna that just handle my employer's portfolio of aetna accounts...so i guess working for a big company pays off even though the top CEO doesn't know u from left or right.....!!!

The slight disappointing thing is that my surgeon is going to be out for 2 weeks, so i won't even be able to meet with him until 6/4/09 :crying:..meaning im probably not looking at surgery date until mid to end june!!! blahh!!! but im glad i no longer have to worry about being denied!! I gained 7lbs during 90day pre op, skipped one mnth, and made it up end of april, and didnt do a psych eval, b/c it isnt required by aetna nor my doctor, if i didnt have any previously psychiatric issues......

Edited May 14, 2009 by ahb08

[elgrad 0]

CONGRATULATIONS! I hope my approval goes as quickly. I have Aetna also. I have one more nutritionist appointment in June and that should be the end of all the pre-op stuff. I am so excited for you. Keep posting so that we will know how everything goes and good luck!

Elgrad

[talkalot1981 5]

OH congrats. I also hope my approval goes that fast. I don't have Aetna but my other referral requests were approved with in a day. My first referral was to see the surgeon. Appoved next day. Then had problems with that surgeon so I requested a different surgeon and approved to see new surgeon day after request. So I hope this is the start of my good luck. Congrats again...... Jennifer

[Huskergirl 0]

I'm glad to hear someone was approved through Aetna. Another person posting was not approved. I would like to pose to you the same question I had for her - who did you use for a dietician and "exercise therapist"? I called and they (Aetna) said that a personal trainer or going to Curves would not be accepted. Any advice would be appreciated. I want to make sure I cross my t's and dot my i's to the letter.

Thanks in advance.

[ahb08 0]

I'm glad to hear someone was approved through Aetna. Another person posting was not approved. I would like to pose to you the same question I had for her - who did you use for a dietician and "exercise therapist"? I called and they (Aetna) said that a personal trainer or going to Curves would not be accepted. Any advice would be appreciated. I want to make sure I cross my t's and dot my i's to the letter.

Thanks in advance.

Hi there huskergirl...ok i have read before on this website how other people who were approved with aetna, and there was no need for an exercise therapist/supervised watch.....and since i was approved without that, its true...basically here it was u need to do..and this goes for anyone with aetna....find a doctor's office and or a surgeon who has an office of their own who solely focuses on bariatric surgeries, b/c insurance companies like when u go to physicians offices who handle those, b/c usually they already have dietician's and nurse practitioners at their practive that could have the quals of a regular doctor who can be the one that notes how ur doing during the 3 or 6 month regimen and they are experienced on how to word everything on each of ur visits (documentation seems to be the key in these approvals)...the 6 month thing specifically says something about supervised exercising (but i have seen people get approved just with notations of the doc notating the patient is exercising), but the 3 month one is solely on preparing for the surgery (if u can find a place in ur area who is focused on bariatric care only then the 3 month plan would be acceptable b/c u went straight to the source, instead of going to ur regular pcp for the monthly visits and him just referring you to a surgeon later.)

[Ronda1966 0]

Huskergirl,

I had Aetna Pos ll ,and I used my Weight Watcher memeber weigh cards and my Curves weight and measure card also . I did not have insurance for about two years . I also used pictures that I sent in . I did the 3 month jump start program with my surgeon started everything 9-27-2008 I ws approved Dec.24th 2008 ,and had my surgery January 14th of 2009. I have losted to date 56pounds of unhappiness. I feel great !! Yesterday I went to buy a pair of pants from size 22 to petite 14-16, then I decided to pick up a new shirt from 3x to large in the regular size section of clothing . I went to the dressing room to try them on and stepped outside the door to show my husband .I said I looked wonderful . I went back in to look again ,then I started my happy dance just looking at myself and how far I have come since my surgery.I wish everyone the same joy I feel with was worth it .Best wishes to all!!!

I don't know how to change my scale so sorry .I'll figure it out sooner or later

Edited May 16, 2009 by Ronda1966
add another line

[Lady Lap Band 71]

I told you Aetna was a breeze to get approved! I had the very same thing happen to me, they approved so fast! Congrats! let us know when you get your date!

[ahb08 0]

Huskergirl,

I had Aetna Pos ll ,and I used my Weight Watcher memeber weigh cards and my Curves weight and measure card also . I did not have insurance for about two years . I also used pictures that I sent in . I did the 3 month jump start program with my surgeon started everything 9-27-2008 I ws approved Dec.24th 2008 ,and had my surgery January 14th of 2009. I have losted to date 56pounds of unhappiness. I feel great !! Yesterday I went to buy a pair of pants from size 22 to petite 14-16, then I decided to pick up a new shirt from 3x to large in the regular size section of clothing . I went to the dressing room to try them on and stepped outside the door to show my husband .I said I looked wonderful . I went back in to look again ,then I started my happy dance just looking at myself and how far I have come since my surgery.I wish everyone the same joy I feel with was worth it .Best wishes to all!!!

I don't know how to change my scale so sorry .I'll figure it out sooner or later

thats awesome girl!!!! im happy for the drop in dress sizes for u.....i know u wanted to scream at the store!!!!!

[ahb08 0]

I told you Aetna was a breeze to get approved! I had the very same thing happen to me, they approved so fast! Congrats! let us know when you get your date!

I know...u were right.....and i will definitely tell u when i have my surgery date!

[Huskergirl 0]

Thanks and congrats to all of you who have Aetna. I have another question - did your bariatric Dr. send in precertification after your initial visit? I'm a little fuzzy on the steps that need to be taken.

[ahb08 0]

Thanks and congrats to all of you who have Aetna. I have another question - did your bariatric Dr. send in precertification after your initial visit? I'm a little fuzzy on the steps that need to be taken.

no they didnt send no type of precertification...all they did after my first visit was just verify that my insurance cover's it and how much they would cover....

[BethL 0]

I'm with Aetna and I'm doing my 3 month supervised physician weight loss. I did my first visit on April 24th, second visit on May 12 and scheduled for June 12th visit. DO you think this will work for Aetna? I read someowhere that it had to be around the same time each month. If so I need to schedule another visit for the end of May and end of June. We're shooting for a July surgery date.

[Jodi73 11]

We are on the same track! I did my first visit with my PCP on April 22, my next will be June 1, then one more I have not scheduled yet. I also have to see a nutritionist and excersise ther. Do you? Let me know how things go for you!

Jodi

[ahb08 0]

I'm with Aetna and I'm doing my 3 month supervised physician weight loss. I did my first visit on April 24th, second visit on May 12 and scheduled for June 12th visit. DO you think this will work for Aetna? I read someowhere that it had to be around the same time each month. If so I need to schedule another visit for the end of May and end of June. We're shooting for a July surgery date.

BETHL, if you're doing the 90 day....u need to actually go to 4 doc visits.....and the consult includes as one...., and from what i heard the visits have to be 30 days apart no more than 35 days..., but i was approved with a 60 day gap in my visits, but with that it prolonged this process b/c i had to do my 4th visit end of april..and now im just waiting on a date...if i wouldnt of skipped my jan 30th visit..i would of been finished march 30 with doc visits..and i probably would be having my surgery this month!!! Here is an example of the visting guidelines my case manger at the surgeons office gave me for aetna requirments....by the way, I only did 2 nutritionals..my case mgr said that lately aetna has been approving with only 2 nutrional visits....and if your doc doesnt require a psych eval..then u dont really have to do it, unless u have a history of psychiatric disorders or problems, per aetna obesity requirements..and im proof that's true, b/c i didnt do a psych eval.

12/31/08- Start Weight loss program with AIGB-Start

(Your Initial Consultation counts as your 1st visit)

01/31/09- 2nd Weight loss visit with AIGB-30 days

1st Schedule an appointment with the Nutritionist

02/31/09-3rd Weight loss visit with AIGB-60 days

2nd Schedule an appointment with the Nutritionist

03/31/09-Last visit with AIGB for the Weight loss program-90 days

3rd Schedule your last appointment with the Nutritionist

[adelarosa33 0]

Hmmm I have Aetna QPOS...my BMI is like 40.1....i did all the steps..i am just worried that i lose a few pounds and my BMI goes under 40..I have proof of a gym membership but I havent gone because i dont want to lose more weight...do they check the times you go...or is a membership enough??