Guest guest Posted November 28, 2003 Report Share Posted November 28, 2003 Hello! I have a question for anyone who has Aetna HMO. My fiance is going through the process of having the RNY (I had mine May 20, 2003). He had his initial consultation with Dr. Abkin in town, NJ. Anyway, we found out that w/ Aetna he needs to have a documented 6 month doctor approved diet plan. My fiance has done Dr. supervised diets in the past (optifast), however Aetna wants something within the past 2 years. We went to his primary doctor who referred us to a nutritionist. I checked w/ Dr. Abkin's office and spoke with the insurance contact there. She advised me that the nutritionist is not enough for Aetna to approve...it needs to be an actual Doctor who supervises his diet. She gave me the name of a doctor who they refer people to, however he doesn't take insurance and charges $100 per visit. For 6 months, it would be about $600. Unfortunately, $600 is alot for us now since we are planning on getting married and have alot of other expenses. So, I was wondering what other Aetna HMO people have used or done. Were any of you able to get around this stipulation? If not, what kind of doctor have you used? My fiance said the last time he did a doctor supervised diet he was being seen by an endocronologist. We just don't want to waste another 6 months seeing the wrong doctor or using the wrong diet plan and then find out it wasn't what Aetna wanted. My fiance is classified as super morbidly obese, is type 2 diabetic, and has severe sleep apnea. We both want to get this done as soon as possible. If you are from NJ, would you mind giving referrals of doctors you used? Anyone in the , Passaic, Bergen or Essex Counties. Please email me your replies to farfallanero@... Thanks Again!!!! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2003 Report Share Posted November 28, 2003 I have Aetna Managed Choice PPO. My surgeon sent me a letter saying that supervised weigh ins would probably be required. I hope they will take a documentation from a nutrionist, since my primary doctor referred me to a nutritionist and she has written a very comprehensive letter for me. I've been working with her for two years. I've also gotten letters from other providers who've treated me as well, but the only supervised weigh ins are from my nutrionist. I must say that this is the kind of thing that really upsets me since it clearly is a tactic to put off the paying for the surgery and not to justify medical necessity. Good luck. I'd love to hear what you find out. > Hello! > > I have a question for anyone who has Aetna HMO. My fiance is going > through the process of having the RNY (I had mine May 20, 2003). He > had his initial consultation with Dr. Abkin in town, NJ. > > Anyway, we found out that w/ Aetna he needs to have a documented 6 > month doctor approved diet plan. My fiance has done Dr. supervised > diets in the past (optifast), however Aetna wants something within > the past 2 years. We went to his primary doctor who referred us to a > nutritionist. I checked w/ Dr. Abkin's office and spoke with the > insurance contact there. She advised me that the nutritionist is not > enough for Aetna to approve...it needs to be an actual Doctor who > supervises his diet. She gave me the name of a doctor who they refer > people to, however he doesn't take insurance and charges $100 per > visit. For 6 months, it would be about $600. > > Unfortunately, $600 is alot for us now since we are planning on > getting married and have alot of other expenses. > > So, I was wondering what other Aetna HMO people have used or done. > Were any of you able to get around this stipulation? If not, what > kind of doctor have you used? My fiance said the last time he did a > doctor supervised diet he was being seen by an endocronologist. We > just don't want to waste another 6 months seeing the wrong doctor or > using the wrong diet plan and then find out it wasn't what Aetna > wanted. My fiance is classified as super morbidly obese, is type 2 > diabetic, and has severe sleep apnea. We both want to get this done > as soon as possible. > > If you are from NJ, would you mind giving referrals of doctors you > used? Anyone in the , Passaic, Bergen or Essex Counties. > > Please email me your replies to farfallanero@y... > > Thanks Again!!!! Quote Link to comment Share on other sites More sharing options...
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