Question:
Has anybody been approved with dietician vs PCP documentation?

I have been denied by Aetna because my 6 months supervised diet was documented by a dietician rather than my PCP. It has been sent for a second level appeal, I should hear back in a few days. Just wondering if anyone got around that? Thanks.    — K S. (posted on April 23, 2003)

April 23, 2003
I was just approved thru the outside grievance procedure- ihad no documentation in medical record-just a letter from my PCP. Aetna was trying to make me abide by the new policy when i filed under the old. Even though the old one said "documentation from the medical record", they were accepting letters from the PCP. You should see if your regular doctor will put in your medical record the notes from the dietician. If not, go the distance with the outside grievance committee. Make sure you put everything in that packet-even notes from Associations that say WLS is the treatment of choice, another letter from your dietician saying again all you have done. You have nothing to lose by trying if Aetna denies again. Good luck!
   — toni S.

April 23, 2003
I have Cigna and am presently trying to get them to accept my documentation from the dietician. I have been told by my dr, office that Aetna is fae stricter than Cigna on the supervised diet issue. I will probably have to complete another 6 month run o dieting to satisfy them. my advice would for you to start on a supervised diet with your dr, now just in case they refuse you again. At least then you will be on your way toowards that end and if they do approve your appeal you have nothing lost accept maybe a few pounds. Good luck.
   — bubbleboo K.