Recent Posts

Nan2008
on 10/24/12 9:02 pm - Midland, MI
Topic: RE: Aetna Choice+ POS II- 3 month documentation (again)
I will PM you the info . 

Nan

HW 300
/ SW 280 / CW 138 /
GW 140
Hit Goal 4/2/2010

        
Andrew V.
on 10/24/12 10:05 am - La Porte, TX
Topic: RE: Aetna Choice+ POS II- 3 month documentation (again)
Could you please PM this info?

Thanks,

Andrew
songbird177
on 10/24/12 7:35 am - Carmichael, CA
DS on 12/03/12
Topic: I Fought My Insurance for a DS and Won! (anthem/medi-cal) (cross post)
http://www.obesityhelp.com/forums/amos/4579774/I-Fought-My-Insurance-for-a-DS-and-Won-anthem-medi-cal/
Nan2008
on 10/23/12 12:39 am - Midland, MI
Topic: RE: Aetna diet
Hello - I have Aetna and myself and all three of my kids have had surgery and were approved through Aetna.  You DO have to do a physician supervixed diet by completing a 6 month physician supervised diet or the 3 month Multidisciplinary program. 

If you go to Aetna.com and type in 0157 in the search box it will bring up the clinical bulletin that lists the requirements needed for approval.  I can send you a PM to let you know everything we did and what you need to do to get approved if you would like. 

Nan

Nan

HW 300
/ SW 280 / CW 138 /
GW 140
Hit Goal 4/2/2010

        
amandawood1978
on 10/23/12 12:38 am
Topic: RE: Aetna diet
That sounds great!!  Thanks so much for your help :)
Nan2008
on 10/23/12 12:17 am - Midland, MI
Topic: RE: Question on 3 month option with aetna
Hi - I have Aetna and I had surgery along with my three kids.  We all were approved doing the 3 month multidisciplinary program.  Two of us were denied at first and I had to appeal but it was overturned.  I have documentation I can send you if you have questions about what is required. 

You don't need to see an exercise therapist, we simply documented our exercise with our physician. although, we did see a dietician who also was an ercise specialist and she documented our exercise program. 

I will send you a PM with further info of how we got approved though Aetna and if you have questions feel free to PM me!

Nan

Nan

HW 300
/ SW 280 / CW 138 /
GW 140
Hit Goal 4/2/2010

        
Nan2008
on 10/23/12 12:12 am - Midland, MI
amandawood1978
on 10/22/12 9:55 am
Topic: Aetna diet

My agent told me Aetna does not require a diet in order to be qualified for surgery.  Does anyone know if this is true?

kimberlygpena
on 10/19/12 7:27 am - Angleton, TX
RNY on 09/24/13
Topic: Insurance wording
I have BCBS of TX PPO I have been reading my Benefits book and it has this listed for wieght loss:




Any servicesAny services or supplies provided for reduction of obesity or weight, including surgical
procedures,
even if the Participant has other health conditions which might be helped by a reduction of obesity or
weight. or supplies provided for reduction of obesity or weight, including surgical procedures,
even if the Participant has other health conditions which might be helped by a reduction of obesity or
weight.

But it also states exculsions:

Any services or supplies which are not Medically Necessary and essential to the diagnosis or direct care
and treatment of a sickness, injury, condition, disease, or bodily malfunction


 If the DR states this medically necesasry do you think it may cover weight loss surgery.


Any comments welcomed.

Thanks
Glow2254
on 10/18/12 1:12 pm - LA
RNY on 02/28/13
Topic: RE: Question on 3 month option with aetna
Ok well then I am heading in the right direction. I joined a gym and the trainer there agreed to document my progress. Thank you that helped clear my confusion. How long did it take for yr approval?
Mrs. Glow    
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