Received a letter from Aetna......... - ThinnerTimes

NYNMD · 05-01-2005, 08:42 AM

Saying I need a letter of medical necessity and office notes documenting any physician supervised diet attempts within the past two years.

The letter didn't say denied, just a statement that they are completing a review and determination, and additional info is required.

They gave me 45 days to address the issue. Do you think this is a good or bad!!

I can certainly get the letter of medical necessity and hopefully my dietician can re-do her letter. Apparently, a summary letter of my progress is not good enough.

I'm a little confused!! Any advice is welcomed.

Bypassingme619 · 05-01-2005, 09:13 AM

No.. No Kimmy this is still good. A NO is the only bad thing we are looking at. They are giving you a chance to turn in needed documentation. Some insurance companies will just give you a NO without even requesting any type weight management documentation. Have whom ever type what they can for you and if you, yourself have and documentation you can add such as logs kept during your diets of meals and exercise attempts that would be great as well. They gave you a good amount of time to get thoes things in order. My prayers are with you Kimmy. You almost there don't drop your hopes. I know this is the hardest part of the whole process the waiting. God Bless you Kimmy.

LizardQueen · 05-01-2005, 09:21 AM

I think that sounds hopeful. It's hard to see what insurance companies are thinking, but if thye want more info get it to them ASAP. I always faxed all of my stuff. That way you know it's there and you know it got there within the time frame. Good luck!

Amber

NYNMD · 05-01-2005, 11:44 AM

Thanks guys,

I wasn't sure if this was bad or good. I might have a little trouble getting my dietician to comply, but I sent her an email with the Aetna requirement from the bulletin 0157. I'm certainly not going to give up.

tazbabygirl69 · 05-01-2005, 12:07 PM

Kimmy,
I have Aetna as well. They want the weekly/monthly progress notes from your dietician showing your weigh in, what you ate and how much you excercised.

virgo · 05-02-2005, 07:56 AM

I can't see him turning you down it they want the additonal information.I have medic choice and they told me that was a good insurance so my surgery is now schedule for June 3

. My doctor in in Smith here in Minnesota and I have done a lot of research and found out that he is good doctor so that makes me feel better. I am going to have to have a open RNY because of a previous surgery I had he doesn't feel comfortable doing a LAP so I will have a long recover peroid.

I am a little relief that it is going to be in a month it will give me all the summer to run and work out.
When I was at the information meeting so I knew for sure if I wanted to go this way they told us to remember the word POWER and what each letter stood for and if we did that we would have no trouble losing the weight and staying tone at the same time. They also said to "eat to live not to live to eat" and as I thought about that I realize that is what I was doing.So I have stated to change my eating habit now and am sipping all of my water everyday.I have increase my walking. I am now going to remember that I don't have to be putting something in my mouth all the time to be happy and to forget about things. I will excercise and drink water and look forward to that thin body that I will have. So anyway I have a month and I can start a new life as I look at it the pain in my joint will start to go away and I will not have to take all the medicine that I am taking right now.
virgo

misty gunn · 05-02-2005, 11:53 PM

Hi I am new to the forum I just did my last test and I have atena ppo.
Do I need to worry?

tazbabygirl69 · 05-03-2005, 05:51 AM

Quote:

Originally Posted by misty gunn

Hi I am new to the forum I just did my last test and I have atena ppo.
Do I need to worry?

Actually the PPO may be a little easier to get approval from. A co-worker switched to the PPO plan just so she didn't have to meet some of the requirements of the HMO. I personally didn't have the 8K out of pocket cost that she is having to deal with now almost a year later. I'll jump through the HMO hoops for that kind of money.