Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Aetna Sleevers Please Help If You Can, My World May Have Just Crumbled.



Recommended Posts

I'm hysterical right now. I've got my final PCP visit this afternoon so I called my surgeon's office to find out what documentation they needed from her. Day 90 of this 3 month program is November 15th so I want to make sure everything is in order long before then. My last nutrition and psych/behavioral appts are next Monday.

She said the notes from the visits. I asked about the 2 year weight history. I remember reading that I needed documentation that I've been fat for at least 2 years. She said oh yes, notes from 2010 and 2011 also. I said I didn't think there was a note from 2011, but lots from 2010, 2009, 2008, etc.

Nope. They will reject it unless it's the previous 2 years.

Which would mean I couldn't have the surgery until 2014.

And all this hope and planning and appts I've been going to since the end of July are all in in the dust at my feet. I'm so nauseous and dizzy I can barely breathe.

Obviously I need to verify dates at my appt today, but in my gut I know there's no 2011 weight.

I had given up for most of 2010 and all of 2011. I wouldn't even step on a scale.

Share this post


Link to post
Share on other sites

It’s open enrollment time - is there a possibility of changing plans now? Just thinking out of the box and how you can possibly still get what your looking for.

I KNOW I refused to step on the scale often - so I may be in the exact same place as you when my waiting time is up in January. I have to wait six months.

Share this post


Link to post
Share on other sites

Call your insurance company and ask them. Tell them there are detailed notes for the other years, and find out if that's a deal-killer. Also, find out if you can have the surgeon submit it that way, then appeal if it's rejected. Best of luck!

Share this post


Link to post
Share on other sites

Just take a deep breath and try to calm down. I had the similar, although I didnt have your same insurance, It had been over the two year mark since I had seen a nutritionist, but I wrote down everything I had done, in detail, submitted it and they accepted it. All you can do is give them the info and see if they will go for it. Hoping you can get it approved!

Share this post


Link to post
Share on other sites

No other insurance choice for me. Just Aetna. Find out now or you may have to repeat the 6 months. I can't believe I'm just learning this now.

Share this post


Link to post
Share on other sites

Raven......did you have any weight documentation anywhere else? Like from a job pre-screening, curves, weight-watchers.......etc.

Share this post


Link to post
Share on other sites

Have you been to any walkin clinics or emergency rooms in 2011?

Share this post


Link to post
Share on other sites

What about OB-Gyn? Any records there?

Share this post


Link to post
Share on other sites

Talk to your PCP and see what he/she says. Dont panick.

Share this post


Link to post
Share on other sites

I'm hysterical right now. I've got my final PCP visit this afternoon so I called my surgeon's office to find out what documentation they needed from her. Day 90 of this 3 month program is November 15th so I want to make sure everything is in order long before then. My last nutrition and psych/behavioral appts are next Monday.

She said the notes from the visits. I asked about the 2 year weight history. I remember reading that I needed documentation that I've been fat for at least 2 years. She said oh yes' date=' notes from 2010 and 2011 also. I said I didn't think there was a note from 2011, but lots from 2010, 2009, 2008, etc.

Nope. They will reject it unless it's the previous 2 years.

Which would mean I couldn't have the surgery until 2014.

And all this hope and planning and appts I've been going to since the end of July are all in in the dust at my feet. I'm so nauseous and dizzy I can barely breathe.

Obviously I need to verify dates at my appt today, but in my gut I know there's no 2011 weight.

I had given up for most of 2010 and all of 2011. I wouldn't even step on a scale.

[/quote']

I'm sorry please keep us updated. Your dr might be able to help

Share this post


Link to post
Share on other sites

Yes did you use any hospital during 2011? Care now? Prima care? ER or gynocologist? If they weighed you then you can use that.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • rlcpd

      Two months out from hiatal hernia repair.  Surgeon said to expect a lot more flatulence...something about the 'air' no longer being able to 'burp' out so comes out the other end.  That is my experience but have no understanding of why that swallowed air cannot be 'burped'. ???
      · 1 reply
      1. BlondePatriotInCDA

        As I understand it since your stomach is smaller and not completely resting against your diaphragm anymore you no longer have the ability to "push" burps out as well. Plus, since its smaller and we don't digest slower the trapped air moves a lot quicker out of the stomach so its no longer available to burp out. Hence the other option for removal.

    • Lizette1122

      Anyone had the TORe procedure? How did it go? How much weight did you loose? 
      · 0 replies
      1. This update has no replies.
    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×