JDUB0414

I have Aetna and have been denied because I only have four of the five years needed to get approved. I just filled out the form on obesitylaw.com. Has anyone here used them?

OMG!!!! This is great news for my husband. The whole reason he got denied was because we only had 4 years weight history instead of 5. Thanks for the great news!!!!!

Thanks everyone. We just wrote a letter and are waiting on the letter from PCP also.

He was denied by Aetna in January. Do you think we should appreal first then go to obesitylaw.com? Why did you get denied? What did you do for your appeal? thanks for your help.

The same thing happend to me. The only difference is I didn't and still dont have a surgery date, but they would'nt allow me to come to the surgery orientation to get my date until they had letter in had. It only took a few days for me to get it, but for whatever reason the surgeons office took forever to get it. Same thing as far as them not doing anything, even when the insurance coordinator said that's all they had to do. I emailed my nurse at the surgeons office a copy of my letter, then she scheduled my orientation date. The bad thing about this is the fact that they only offer orientation once a month, so by the time she got my copy of the letter, January was booked up. I had to wait till February 20th...which is coming up. She then said they are booking surgeries four weeks from when I come in because the doctor only does surgery on Wednesdays. :eek:

this is actually for my husband.

I also have Aetna and have been denied because I only have four of the five years needed to get approved. I just filled out the form on obesitylaw.com. Has anyone here used them?

Thank you. Green, I agree with you. It's been talked about since for ever, that's why I get frustrated when people act as if they dont understand why we get so offended by it.

lonestar good luck. coolcrystal congrats.

I found this forum to be very entertaining. There isn't anything wrong with what Opera does. She's an entertainer!!! If you dont like the way she talks, then stop watching her show. I dont watch her show, because I have a JOB. So unfortunately everthing I hear about her is through the media. I know that most people on here don't understand why some of us were offended by the post, but if you were "BLACK" you would. Yes we've come a long way with "racism" and "prejudice", but whether we like it or not, it's still prevalent. If you consider yourself not to be either of the words I mentioned in my previus sentence you would understand why some African Americans get offended when people say we talk "BLACK." Like one poster said, lets not act like this is a new thing that's going on. We all know that when people say you talk BLACK that means that your not articulate, you speak with slang, and you sound ignorant sometimes. If you dont want us to be offended by your comments and post statements defending such things, then dont post on a public thread. Hope everyone has a nice day!!!

Hi All, I'm a 27 year old AAF and found this thread to be very interesting. I'm usually very argumentative when it comes to spats like this, but I think that the initial post wasnt read correctly by some. She was just asking if anyone had found any research on this and from that some people are taking it very personal. Everyone is different, so there may very well be truth in AA loosing weight at a slower rate. If you think otherwise, there's no need to get upset about it, just state your opinion and move on. I will be going to my consultation on 2/20/08 and am hopeful to get my band date for early March. I'm so happy!!!! I will say that I'm excitied about meeting other AA who are getting or who have had the band. Congrats to all of those who have had success and who will be getting the band.

My husband and I both have Aetna. I've been approved and my husband hasn't. The reason is because he doesnt have 5 year weight history. He only has 4 years. We've spoken to the insurance company and they say the surgeons office has to resend the info. The surgeons office says we have to resubmit it ourselves. Because we only have 4 years, I dont know what else we can do. If there is anyone out there that can give us some feedback on appeals that would be great. Any advice would help.:smile:

My doctor wrote a letter on her letter head with the year and my weight for that year.

reif 78, How many years did you have? Do you hace a copy of the letter that your dr. sent?

I have Aetna, yes they are strict. I got approved after the whole six month diet and after six weeks of submitting my papers. My husband on the other hand had the exact same thing, but only had 3 years of weight loss history....only because he hasnt been to the doctor, and got denied. Now we are trying hard to find to figure out how we can appeal.

Hi All, I'm going to have the surgery by Dr. Delatore sometime in March. Any good/bad feedback with regards to this doctor?

Congrats on you approval:biggrin:

Even though it took a while for them to approve me I think....I got approved after 6 weeks or so. I've had a BMI of over 40 for the past five years but have absolutely no co-morbids. The previous poster is right, I think it depends on the person reviewing your file and what mood their in. Good Luck.

right!!! As of today they doctors office still doesnt have my approval letter and wont do anything till they get it. I've had mine for a few days now and the nurse finally said I can send her a copy of mine. The insurance company doesn't know why they have received it yet, but said the nurse could call her and she will give her all the info she needed for the approval. The nurse refused to do that and said she needed it in writting. What makes this worse is that, the class that I have to go to wont be offered again until the end of next month!!!! OMG what the hell is going on!!! I'm so sick of this unecessary bull crap. I asked the nurse today why so many simple things are falling through the craks and no once seems to care. She didnt have an answer of course.

This is my story. The weight loss center sent over what I thought was all my paperwork on 11/19/07 to the insurance company. I received a letter from them on 12/7/07, after calling them regularly for two weeks with regards to the status of my file...stating that they need additional paperwork. I dont know whether or not to be pissed at the nurse at the wieght loss center or at my PCP office. The nurse said she knew exactly how Aetna works and would not send my packet to them unless she had the complete file. I gave them both the print out of what I needed to get approved. Well somewhere along the way our five year weight loss history didn't get sent. I called my PCP on 12/10/07 to ask them to send that info to the weight loss center ASAP and was told they would send it the next day, talked to them 12/15/07 and they still hadn't sent it and was told they would send it on 12/17/07. Talked to them this morning, and they still haven't sent it and would get it out by 12/21/07. Now on the letter I got from the insurance company, said I had 45 days till the date that the file was opened to get them the info or they would make a decision about without the five year history. To me this means they will deny it. My PCP acts as if it's not important enough to rush the letter and it will take a week to get a copy of my medical records. I dont know what to do. I am so upset!!! What should I do?:whoo:

I'm a high shool Spanish teacher

jess4houston-I think curves will only count, if your doctor puts that in your file during your visits. I have a form that I got from another member on here that my doctor filled out. We sent that instead of all her medical notes. It worked. Annielkd-thanks for your motivating words. I cant wait!!!

that's good destiny. i'm waiting on my surgeons office to call me now, so I can find out about the fills.

Circa, that is ridiculous!!! Instead of me sending the entire file. My doctor sent a letter on her letterhead, with the year and weight I was at that year. It look similar to this. 2007-340lbs 2006-320lbs 2005-300lbs So on and so forth. the reason my husband want approved was because he only had two years. we found the other three years and will be sending them asap. Because he didnt have them, they also deemed him not medically necessary...he weights about 310lbs!!!

thanks!!!!!