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Insurance Discuss insurance topics for the gastric bypass and Lap BandŽ operations.

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Old 09-30-2009, 05:55 AM   #1 (permalink)
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Join Date: Jun 2009
Location: Round Rock, TX
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Default 3 Months or 90-Day NUT Requirement?

My Surgeon's office got the message yesterday when my AETNA/DELL response finally came through.

While they had been scheduling 3-month Nutrition evaluations for ages for AETNA PPO here in the state of Texas, the message back to the Patient Advocate for me and another patient was that it has to be 90 days, which means no less than 90 days, which means FOUR NUT visits, folks.

I know from seeing signatures of many on the forums over the last 4 months that there were lots of people approved with three visits.

Not any longer--at least if you're in the State of Texas.

The DELL/AETNA insurance also added a new requirement in the last week that we must show at least two years of weight notations within visits with a professional health organization (no WW, Jenny Craigs, etc.). Wasn't part of my requirements, and never updated to us until yesterday.

So, if you are AETNA in Texas--please schedule a 4th visit with your NUT;
Would suggest if you're AETNA anywhere else that you check on requirements to ensure you don't fall into the same trap that I have.

While I was tracking down my old doctor during my year stay in Colorado, my PA was busy calling 20 other AETNA patients to tell them they needed another visit to the NUT.
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Old 09-30-2009, 07:17 AM   #2 (permalink)
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Location: Arlington, TX
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I don't know how they can change the requirements on you after you've started with a doc but they do it! Makes me mad...

Hang in there!
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Old 09-30-2009, 08:46 AM   #3 (permalink)
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I understand them changing rules. I finally got approved after 3 times being denied. They changed the requirements after I met them all for my 3rd time and the 4th them was the charm. Surgery scheduled for 10-18, keep trying and pushing and things will work out.
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Old 10-08-2009, 01:11 AM   #4 (permalink)
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Beth,

What I found odd was the fact that they require the stress test, but when the stress test was submitted for payment it was denied by Aetna. Little bizzar?

Deb
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