Thanks so much! I did the three month diet and I have sleep apnea. I met the baseline for the Aetna requirements. I have a BMI of 36 and an Apnea/Hypopnea Index (AHI) of 15.6 which qualified for the treatment of Obstructive Sleep Apnea under the Aetna Clinical Bulletin. Aetna denied my claim at first because they said that my sleep study doctor didn't sign my sleep study results (however it was digitally signed) and that they needed a definition of hypopnea from the sleep center. I went back to the doctor who reviewed my sleep study and had him sign the report and got the sleep center to provide the definition. I provided all of my information to my bariatric coordinator who reviewed it. She was then able to set up a peer to peer review between my surgeon and the reviewing doctor from Aetna. After the phone conversation, my bariatric coordinator submitted all of the information that was discussed to the Aetna doctor. Once he reviewed it, he overturned my denial and issued my approval! That was great because I wasn't required to submit a formal appeal. I LOVE my surgeon and his staff!
I must say that I thought Aetna was great to work with all in all. If you have a legitimate claim and have jumped through all of the hoops, you will be approved! :tt1: