RE: Aetnas Insurance

[Guest guest]

I have Aetna HMO. I just followed everything that they required and

they had no choice but to approve. Go online to www.aetna.com and look

up their policy for obesity surgery. It is policy #159 or 157, but I

think 159. It will spell everything out in black and white as to what

you need to do. It is possible, just stay on them. I would be happy to

answe any other questions you might have.

Dora in Tennessee

Open/Lap RNY 9/20/04

Vanderbilt Hospital

[Guest guest]

I did the 3 month program with a dietician. I did not have records of 6

months with my doctor either. And even if I had records it had to be

within the last 2 years. Luckily Vanderbilt where I am having my

surgery has a Center for Human Nutrition and they have both a 3 month

and 6 month nutrition program that we can enroll in. It cost me out of

pocket to pay for it. However, I work with a lady who go authorization

for Aetna to have the cost of the program reimbursed. Their rules say

that it has to be 6 months physician supervised or a 3 month

dietician/nutritionist program. But be sure that if you go into a

nutrition program that it is supervised by a doctor. Every time that I

met wtih the dietician she had her notes signed off on my the doctor who

supervised her and then faxed it to Aetna for me. Ask your surgeon's

office, because I am sure that they have dealt with Aetna and can refer

you to a dietician program that will take you less time.

And one thing that I would suggest is that you follow every step of the

way yourself. Do not rely on someone else to follow-up for you. I was

on first name basis with everyone in my surgeon's office, the nutritiion

center, and my case worker at Aetna. I had phone numbers to reach them

all and I called regularly to check to see if they had received my

paperwork and to make sure that there was not something that I had not

done yet. Remember that they work for you and you should never feel

like you are bothering them. Good luck, and ask away if I can help

further.

Dora in Tennessee

Open/Lap RNY 9/20/04

Vanderbilt Hospital