Pre-certification with Aetna

I have Aetna so I will be starting a 3 month multidisciplinary program with my surgeon this month.  It is one of the options to get precertified through Aetna.  Has anyone else done this??


Anyone have issues getting precert?

Yep that's the route I took 4 years ago.... in fact, THIS TIME EXACTLY 4 years ago, now that I think about it, I was in the middle fo my 3-months!

Just FYI: Be SURE to provide the weight history for at LEAST the time period your plan specifies because several people  I know were initially denied by them because they were a few months SHORT of the full 3 or 5 years weight history (and they then had to provide the additional info before they got approval).

Lora

Hi Lora-
Thanks for the information.  I was required to give them 2 years of weight history and I think I gave them well over that.  The lady at the surgeons office has been great at handling all this. They have a specific program that they said Aetna needs and it should get me approved!! I hope they are right.

The only part that is hard is that all of this is such a long process!! I am starting my 3 month program may 24th so at least I will be doing something by then!

I can't wait to get the surgery and get moving

Hopefully once you get done and get everything submitted, they will approve yours as quickly as they did mine.  Once they actually received the 50-pages of materials(!) my surgeon's office sent, I had my approval in 2 days.  In also had a BMI of 57, of course, so they didn't need to look at any info on other health issues.

Lora

Wow!! That is super fast for approval.  My BMI is 48 or close to it so they shouldn't have to review medical conditions either.  I hope the approval process goes smooth-

my surgeons office seems pretty on top of all that stuff so hopefully there won't be any major roadblocks