ozzy22

Hi there! I am getting my surgery done next week in Marietta, Georgia. I never had an opportunity to submit letters from previous diets. I have Aetna and was required to do a 90 day program and was just approved this past Tuesday. Good luck with everything!

Wow that is really fast! I'm happy for you! I was just wondering what kind of Protein powder did you purchase and where did you get it from? My surgery is next week and I am trying to get prepared.

One week from today I will be having my surgery. I am so excited yet really scared at the same time. Hopefully everything will go okay. I'm 20 years old at 270lbs. I just have so many emotions running through me I don't even know what to think. I have a pre-op class tonight and tomorrow. Then next Tuesday I meet with my surgeon one last time to talk and weigh-in. Then on Wednesday I get my PICC line. Then on Thurday my surgery is at 12pm. AHHHHH!

lol every insurance is different but I'm sure your surgeon's office will call you the day you're approved. I have Aetna and my information was sent in to Aetna on a Thursday and I was approved Tuesday morning and my surgeon's office called me right after Aetna had called them.

Thank you! I am very excited yet really nervous at the same time. My surgery date is next week on Thursday!

I'm sorry to freak you out! My surgeon's office never told me if it was 100% required or not. They just told me to do it because they were going to submit them. Also, honestly if I were you and they said you HAD to have the food logs I don't see why you can't fudge a little bit. I mean, it's just food logs. My surgeon's office told me that they don't really inspect them or anything.

My surgery is next week! I am just wondering how long I should wait after surgery to start exercising and also how long should I wait to be intimate with my man? lol sorry for TMI, but I was just wondering....

I wanted to create this thread to help people understand what you need to do that have Aetna. I know every insurance policy is different, but with Aenta you generally do the same thing. I know when I started on my weight loss journey I was SO confused on EXACTLY what I needed. I was just approved this morning and I am beyond excited. This is what I did for the 90 day multi-disciplinary program - You need documents showing you have had a BMI of 40+ for the last two consecutive years (or a BMI 35+ with co-morbidities) I went to my PCP and asked for these records myself and faxed them to the surgeon's office. - You need to see a nutritionist once a month for three consecutive months (for example I saw my NUT once in November, once in December, and once in January.) You need to make sure your NUT faxes your information to your surgeon's office. - You need to do some sort of exercise regimen through a qualified professional. My friend is an exercise therapist and we did Water aerobics every Tuesday and she filled out paper work telling what I did. Again, you need to do this for three months! I'm sure you could either get a personal trainer, go to yoga classes, go to water aerobic classes, go to the gym at the hospital. Just make sure someone describes what you did and signs it. - You need to log your food for 90 days (that is for the behavorial modification portion of what they're wanting). Also my surgeon's office said Aetna likes to see that you attened some support groups for behavorial modification. I attended two support groups. - Also ask your surgeon's office if they have a pre-made template titled WLS MD Monitored program. You need to get that sheet of paper filled out at every doctor's appointment. It will have your current weight, blood pressure, and temperature. Then the doctor will just fill out what you talked about diet wise and behavior modification wise. I still have the template in my email address so if you want it please send me a message. My surgeon's office said this template wasn't absolutely necessary, it just makes Aetna approve you faster with a greater advantage of getting approved. My information was submitted to Aetna on a Thursday and I was approved by Tuesday. That is all I did for Aetna alone. Of course your surgeon's office will have you do many other little appointments and all that good stuff. Hope this helps some people out with any questions about Aetna!

I have a friend who is getting VSG (she doesn't have an acct here) and she wanted me to ask you guys a question. If you gain roughly 5-6lbs BEFORE your surgery will it be cancelled? I personally have no idea because my surgery is scheduled for next month but hers is NEXT week!

Thanks 6kiddos. Yeah I've read that on their website before. I am just not sure how many times they're wanting you to see the nutritionist since that bulletin doesn't specify. How many times did you end up seeing the nutritionist?

I'm not really sure. My surgeon's office really doesn't know the question to that either. I know a lot of people that had Aetna that said they saw nutritionist once a month for three months. Hmm, not sure. I will call the insurance company today and see if they can tell me what they're wanting.

I know each insurance policy is different, but I am just wondering if anyone here has been approved by Aetna. Please read what I've done for my requirements and let me know if you think it's sufficient or not: - saw psychologist in November - saw nutritionist once a month for 3 months. Once in Nov, once in Dec, and once in Jan. - saw exercise therapist once a week for three months. She also documented what I did everytime I can in and worked out and documented our talks about nutrition. - filled out three months worth of food logs - went to two WLS support groups - I have 5 years of weight history, two years being morbidly obese - Upper GI appt. - EKG and chest x-ray done - lab work done - pulmonologist done That's all I can think of at the moment that I've done. Please let me know what yall did and if what I did sounds like it should get approved.

Okay so I know this question is random but I am wondering about protein shakes post-op. I am pre-op but my surgery is less than a month away. Right now I can drink a protein shake in about 3 minutes. obviously I know post-op it's going to be MUCH harder to get it down. So my question is....when it's taking you so long to drink you protein shake does it get really nasty from it being room temperature? Or what to do guys to? Put ice in it? lol sorry for being completely random. I guess this just crossed my mind because I rarely put ice in my drinks.

oh okay thank you for explaining! About how long did it take you to get your levels up? I really need mine up in about 3 weeks or less. I'm not even sure if that's possible. I bought some vitamin D supplements tonight and I am taking two a day and starting being in the sun tomorrow. Time to get outside! lol

Well I just got all my labs done last week and the results are in. Everything is perfectly fine but I am vitamin D deficient. My surgeon won't allow be to have surgery until my vitamin D is in normal range. Does anyone know why. I just don't understand why vitamin D would affect surgery...

I have Aetna and I am about to send all my stuff in to them. Why were you denied?

Hi guys. I had my gallbladder removed a couple years ago due to gallstones. I've been reading online and lots of people are saying ever since their gallbladder removal surgery they gained LOTS of weight which is what I feel happened to me. I used to be fairly thin and could lose weight easily and now it's almost impossible. I was just wondering if anyone went into this surgrey with NO gallbladder and had a successul surgery with lots of weight loss?

I know every plan differs, but I just want some rough idea on how much I will need to come up with. I think my plan covers 85%. I was just wondering anyone who was Aetna, how much did you end up paying for everything?

Okay so I just got off the phone with Aetna because I was freaking out. They said it's okay if you gain a little weight during the weight-loss program because weight gain can be caused my retaining water, muscle mass, etc. So I think I'm in the clear! Now, just to get these pesky 9lbs off...

Okay so I have Aetna insurance and I am doing the three month program. I am currently on month 2 (about to be on month 3). In November (first month) my nutritionist weighed me in at 270lbs. I have also been seeing an exercise therapist that also weighs me and in November she weighed me in at 271lbs. At the very beginning of December my exercise therapist weighed me in at 271lbs. I just had my second nutritionist appointment today 12-22-10 and she weighed me in at 280lbs! I've gained 9lbs in December! Yes, I am definitely going to blame it on the holidays. I have been to SO many Christmas parties and it's just hard. Now, I know I can lose that 9lbs by my next and final nutritionist appointment which will be in January. However, I am just a little worried that my insurance company (aetna) will see that 9lbs weight gain and deny me. I mean, I AM going to lose it by my next nutritionist visit and be at my original 270lbs. I am just worried about insurance. So my question is, has anyone gained weight during their weight-loss program but then lost it to be back down to their original level and still got approved? Thanks!

wow, you look great!!!!

I had my evaluation a couple weeks ago. I was in there for about 2 & 1/2 hours. At first he just asked me questions about my life and family. Like how many kids, how's my relationship with my family, do they support my decision. Then he asked questions about "what makes you overeat?" And then he asked about the suicidal questions. I took a 300 page questionaire that was kind of weird. It had questions on there like "I've borrowed money from someone knowing I would not pay it back" True or False? or "I like my thighs" True or False? lol it was honestly just really weird.

lisabug, why did you see your PCP three times? Was it to get a monthly weigh in?

For the behavior modification they said I would need to chart everything I ate for three months. Nov, Dec, and Jan. Also they said I would need to go to two support groups and also chart my exercise. I am going to cover my butt and get weighed once every month for three months. I have Nov taken care of so I just need Dec and Jan and a doctor to sign off on my weight.

Here is what Aetna's website says: a. Behavior modification program supervised by qualified professional b. consultation with a dietician or nutritionist c. Documentation in the medical record of the member's participation at each visit. (A physician's summary letter, without evidence of contemporaneous oversight, is not sufficient documentation. Documentation should include medical records of the physician's initial assessment of the member, and the physician's assessment of the member's progress at the completion of the multidisciplinary surgical prepatory regimen.) d. Reduced- calorie diet program supervised by dietician or nutritionist.