virtuousbutterfly

Hello all, I am new to posting. I've just finished my work up with my surgeon and my information has been submitted to my insurance company for approval. Has anyone had any experiences with Aetna Open access and this whole diet requirement? I'm afraid of being denied.

Cinerbelle

I don't know about "Open Access"...I have the reg. HMO. I was required to do the 6 month supervised diet. Call Aetna...they were very helpful and willing to answer all my questions.

virtuousbutterfly

Thank you Cinderbelle. I spoke with Aetna and they stated that you had to have been on a supervised diet for a cumlulative total of 6 months over the course of 2 years OR a 3 month nutrition program prior to surgery. Is this what you experienced?

Cinerbelle

Mine was a little different because of my medical group. My medical group required the 6 month program to be their specific program...so this is something you need to speak to your PCP about also.

Let me know what happens!

virtuousbutterfly

Hi Cinderbelle, yeah it sounds like you have an HMO. I'm not assigned to a medical group. I have a ppo. I did a weight loss program from 2004 to 2005 off and on to total 8 months and this was medically supervised. Do you think that might work. Dr Callery has already submitted all my info to Aetna. I'm sooo afraid of being denied.

Cinerbelle

I will cross my fingers for you! If Dr. C submitted the paperwork then he must feel it is going to go through. When did he send your info to Aetna? It is never to early to start calling to 1) be sure they got it and 2) see if they have an approval for you!!

Cinerbelle

FYI - Monkeygrly (Kristi) has Aetna and did not do the 6 month supervised diet and got approval....I'm not sure what type of Aetna she has, you might want to PM her and ask.

virtuousbutterfly

Well, I just got off the phone with his office and he is just waiting for my h&P to come out of dictation from there he will submit. I was thinking the same thing. He wouldn't submit if he didn't think I'd be approved.

virtuousbutterfly

How do I PM someone? Thanks for all your help. I think this resource tool they have is great for us.

Cinerbelle

Click on Member List up above. Click on M and Monkeygrly will be on page 6. Click on Monkeygrly and it will take you to her page. Under contact info click on "send private message". Type in a title...it won't let you send your message without one. Type your message and send.