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In a message dated 9/16/00 3:07:52 PM Pacific Daylight Time,

egroups writes:

<< My parents had Aetna. I have to say they were really good with my

parents. My Dad was in a coma for a long time (5 years before he died)

and

I still have his medical bills. They were over one million dollars!!!!!

Unbelievable. Aetna paid everything. >>

Donna:

God bless your family for what you had to endure, to say nothing of what your

poor Dad went through! So sorry to hear about this, but on the other hand,

feel better about Aetna...nothing against them, mind you, just hate change,

that's all.....may I ask why your Dad was in a coma for so long??

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In a message dated 9/16/00 6:26:53 PM Eastern Daylight Time, Ltb3105@...

writes:

<< Donna:

God bless your family for what you had to endure, to say nothing of what

your

poor Dad went through! So sorry to hear about this, but on the other hand,

feel better about Aetna...nothing against them, mind you, just hate change,

that's all.....may I ask why your Dad was in a coma for so long??

>>

Yea, it was an extremely rough few years. Actually, my post was misleading.

My Dad wasn't IN the coma for 5 years; it happened five years before he died.

He was in a coma for 4 months and in the hospital for 5. He had an aortic

aneurism that burst in his chest. They fixed that (they told us most people

die from that) and then 6 months later, all the tubing they put in got

infected. He developed full-body sepsis and infectious diseases couldn't

identify the germ (this is at HUP---a renowned teaching hospital). Three

other people died from the germ. We used to have to gown up head to toe

when we went in to see him. Believe me, I was terrified because of my kids,

PLUS Alison was only a month old. And my Mom was such a strange

bird......we had to go in because often she wouldn't. The problems my Dad

had were HUGE....involving lots of other organs. He had five operations in

one week and before each one we were told he wouldn't make it. I'll never

forget the sight of him with tubes going everywhere into his body and ELEVEN

machines behind him. Amazingly, he went on to live for 5 more years, which

no one could believe. He was a severe alcoholic and no amount of

intervention worked (we had three). We found him dead at the age of 63; died

while sleeping with his Busch beer and Camel cigarettes beside him. Still in

all, he was a good Dad and I miss him.

Then my Mom died very quickly with end phase emphysema (rushed her to ER and

she died less than two weeks later). WE could never get her to go to a doc

til it was too late. The reality was she died when my Dad did. Her death,

while quicker, was harder on me and my sibs. But I guess that's cause it's

different when it's your mom.

Sorry for the long history!!!! But Aetna really did come through. Never a

hassle with paying the bills.

Donna

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In a message dated 9/16/00 7:23:11 PM Eastern Daylight Time, duffey48@...

writes:

<< Sorry for the long history!!!! But Aetna really did come through.

Never a

hassle with paying the bills.

Donna

>>

Gosh Donna, what an ordeal! Sorry. And your Mom only 2 weeks later? How

hard that must have been. Still is I imagine.

Gail

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Donn,

Sorry about my last post, since I'm sure alot of Insurance companies have a

lifetime cap. It was just really hard for us to go through and I needed to

blame someone. $1.9 million is a lot of payments. So don't get nervous.

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In a message dated 9/16/00 9:54:06 PM Eastern Daylight Time,

smilinggail@... writes:

<< Gosh Donna, what an ordeal! Sorry. And your Mom only 2 weeks later? How

hard that must have been. Still is I imagine. >>

No Gail. She died a year and a half later. She was in the hospital for just

under two weeks. But from the moment my Dad died, it was all downhill for

her. Very odd since her last 5 years with him were brutal. Bad news living

with an alcoholic. We all thought her life would get so much better once he

was gone, but it didn't.

Donna

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In a message dated 9/17/00 12:39:33 AM Eastern Daylight Time, MBrayley@...

writes:

<< Donn,

Sorry about my last post, since I'm sure alot of Insurance companies have a

lifetime cap. It was just really hard for us to go through and I needed to

blame someone. $1.9 million is a lot of payments. So don't get nervous.

>>

Oh Hey . Please don't apoligize!! Everyone doesn't have the same

experience. Our insurance (HMO) can be a pain sometimes, but they actually

pay for everything for Maddie without question. But I know lots of people

who really HATE it!!! Also, my doc was awful. The whole thing with my neck

was a mess and I believe I ended up having emergency spinal fusion surgery

because he wouldn't help me. But I just dumped him; not as easy to dump your

insurance company. I should have sued him, but didn't have the energy; Plus

everything turned out alright and I'm now fine.

Donna

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In a message dated 9/17/00 1:15:02 PM Eastern Daylight Time, duffey48@...

writes:

<< No Gail. She died a year and a half later. She was in the hospital for

just

under two weeks. But from the moment my Dad died, it was all downhill for

her. Very odd since her last 5 years with him were brutal. Bad news living

with an alcoholic. We all thought her life would get so much better once he

was gone, but it didn't.

Donna >>

Oh, sorry. I must have read that wrong. That is so sad. I grew up with an

alcoholic step father. I agree, it is bad news!

Gail

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we use to have Aetna, when nathan was a toddler had a a couple years, they

gave us a little trouble, but iowa city docs wrote them a nasty letter and

they paid for everything after that,no prob.shawna.

>From: Ltb3105@...

>Reply-egroups

>egroups

>Subject: Re: Aetna

>Date: Sat, 16 Sep 2000 18:25:57 EDT

>

>

>In a message dated 9/16/00 3:07:52 PM Pacific Daylight Time,

>egroups writes:

>

><< My parents had Aetna. I have to say they were really good with my

> parents. My Dad was in a coma for a long time (5 years before he died)

>and

> I still have his medical bills. They were over one million dollars!!!!!

> Unbelievable. Aetna paid everything. >>

>Donna:

>God bless your family for what you had to endure, to say nothing of what

>your

>poor Dad went through! So sorry to hear about this, but on the other hand,

>feel better about Aetna...nothing against them, mind you, just hate change,

>that's all.....may I ask why your Dad was in a coma for so long??

>

>

>

>

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  • 2 years later...

Hi I was approved by Aetna PPO nearly 3 years ago. They paid in Network

for Dr. R and out of network for the hospital. Can't figure that one out but

took it and said thank you. Phyllis

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Phyllis,

I too have Aetna PPO. I could use any info you would be willing to give

me. If you could call me or give me a number where I could call you so that

you wouldn't incur long distance charges I would be very interested in

talking to you. My number is 860-289-7576. My name is Kris and I live in

Connecticut. I had surgery on 8/12/03. Thanks, Kris

Re: Aetna

> Hi I was approved by Aetna PPO nearly 3 years ago. They paid in

Network

> for Dr. R and out of network for the hospital. Can't figure that one out

but

> took it and said thank you. Phyllis

>

>

>

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  • 2 weeks later...

I have found that Aetna has paid for MGB. For details, go to:

http://www.obesityhelp.com/morbidobesity/mdcomments.php?N=k178

Good luck,

Pam Holder

> Phyllis,

> I too have Aetna PPO. I could use any info you would be

willing to give

> me. If you could call me or give me a number where I could call

you so that

> you wouldn't incur long distance charges I would be very interested

in

> talking to you. My number is 860-289-7576. My name is Kris and I

live in

> Connecticut. I had surgery on 8/12/03. Thanks, Kris

> Re: Aetna

>

>

> > Hi I was approved by Aetna PPO nearly 3 years ago. They paid

in

> Network

> > for Dr. R and out of network for the hospital. Can't figure

that one out

> but

> > took it and said thank you. Phyllis

> >

> >

> >

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  • 2 years later...

We have our aetna patients come for a one hour initial eval with RD, PT,

Psych and NP (med eval) then f/u 3 times with PT and RD to discuss nutrition

and exercise. If psych feels they need further help that is done as well.

We have our NP send out a letter to Aetna stating that this patient started

a medical wt management program with us and she briefly writes about their

specific nutrition and exercise goals (i.e. reduced sodium etc). At all

appointments I have patients set very specific dietary goals typically 2-3

at first appointment and document those goals. i.e. I will limit fast food

meals to 2 per week. I also have them keep food records for at least 6

days out of the next month and request they bring those in. I document

weight at each visit as well as discussion of how they did with their goals,

any stressors/struggles that they had or prevented them from making their

goals and then we set new goals together and I document those. If you read

Aetna's policy they state exactly what they are looking for so we modeled

our appt schedule based on their description. One thing they mention is

" behavior modification " So I always mention in my notes any and all

behavior modification techniques we discussed or I mentioned. I am sorry I

do not have a specific form to send you, but I hope this information is

useful.

Laschkewitsch RD LD

Dietitian, Legacy Obesity Institute

(503) 413-8135

aetna

I have a pt, who has Aetna. They require initial, final, and 2 f/u

visits. I am not familiar with this process. Can anyone help? What do

you document at each visit? how do you charge (per visit or as a whole

for the total number of visits)? Will you be willing to share notes?

Thank you for your help

Araceli Vazquez,MS,RD, LD

Nutrition and Vida

972-470-0743

araxtapia@...

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  • 4 years later...
Guest guest

I have Aetna and it is horrible. While they say that they cover " speech

therapy " , the fact is: They don't. They cover it only if it is

rehabilitative (like if there was a stroke)--not habilitative or if there is

some physical anomaly like cleft palate. You can go to www.aetna.com and

look for yourself at their Clinical Policy Bulletin on Speech therapy.

Click on the Individual and Families tab I think it is and there will be a

medium size square kind of in the middle of the page that says Clinical

Policy Bullentins. Click on it and then choose the Medical one (there are 3

and I can't remember what they all are). And then on the following page

there will be a space to type in the number of the bulletin or key words.

Type in " 0243 " (or speech therapy) and their policy will pop up. I have

gone round and round with Aetna trying to pin them down on what they will

cover and no one will tell me except to point me to this bulletin. I have

had more than one speech therapist in my area say, " Oh you have Aetna? They

are notorious for NOT covering speech therapy! " .

I copy and pasted the link--you can try it to see if it will bring you

directly to the bulletin. Otherwise just follow my instructions

http://searchx.aetna.com/_layouts/search/cpb2.aspx?k=0243 & selectedIndex=0 & s=All+\

sources & pt=SDAV%3ahref%2cContains%2chttp%3a%2f%2fwww.aetna.com/cpb/medical/data/\

%2cAnd%2c & wd=+where+%22URL%22+Contains+http%3a%2f%2fwww.aetna.com/cpb/medical/da\

ta/ & RefURL

=

My daugher who turned 2 in June is now receiving services from our school

district and the University (of Minnesota). A friend suggested that I call

the local university's graduate program for speech, hearing and language...I

did and was placed on the waiting list and got in about 3 months later.

They charge $40 per session and do a sliding scale for those that qualify.

My daughter goes twice a week to the University. A graduate student is her

therapist and she is directly supervised for a licensed speech pathologist.

It's a great option for those whose insurance will not cover or those that

do not have insurance.

Good luck!

--

" Birth is not only about making babies. Birth is about making mothers ~

strong, competent, capable mothers who trust themselves and know their inner

strength. "

- Barbara Katz Rothman

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