Welcome guest, you have 1 message! Register

View RSS Feed

adoptapup

So afraid of a denial

Rate this Entry
HI,

I had my last weigh in two weeks ago after going through a 3 month multidisciplinary preoperative weigh loss requirement for Aetna insurance.

I've been reading through the requirements posted on Aetna's bariatric surgery policy and it states that the member needs to not have a "net" weight gain during the 3 month preoperative requirement. Now as I understood from the Bariatric office that I can't gain any weight from my first weigh in and if I show a weight loss after 3 months I should be fine. But as I understand reading this, is that I can't gain ANY weight during the 3 month process. I'm confused. I will call the office tomorrow but I am sitting here so nervous now. I just got my surgery date today and they just sent into the insurance company this evening.

The problem I'm worried about is that the first month I lost some weight, the second month I gained back some weight but the third and last month I lost all the weight I gained in the second month. Now I'm so worried that I'll be denied because of the weight gain in the 2nd month but nobody in the office said anything about it and they think it won't be a problem. I don't know if I'm reading it wrong but the word "during" is what makes me worried.

Has anybody else went through this process through Aetna?

Thank you

Submit "So afraid of a denial" to Digg Submit "So afraid of a denial" to del.icio.us Submit "So afraid of a denial" to StumbleUpon Submit "So afraid of a denial" to Google

Tags: None Add / Edit Tags
Categories
Uncategorized

Comments

  1. Fae's Avatar
    I have BCBS and went through 6 months with a weight-loss coach. I didn't have to lose a certain amount of weight. I went up and down during those months. I'm so glad I didn't have to lose to qualify. Good luck.
  2. char602's Avatar
    Try not to worry to much. I believe by "net" weight gain they just mean the overall measure after the increases and decreases are considered. Basically if there was an improvement overall. I know the word "during" is throwing you off..it would me too.

    Fingers crossed for you.
  3. Ann2's Avatar
    I read that just like Char does. "Net" means "bottom line."
  4. adoptapup's Avatar
    Thank you for replying. I think I will call Aetna just to find out and hopefully put my mind at ease.