Beckysue
LAP-BAND Patients-
Content Count
54 -
Joined
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Last visited
About Beckysue
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Rank
Senior Member
- Birthday 07/10/1970
About Me
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Gender
Female
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Occupation
Preschool Teacher
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City
Palmyra
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State
Virginia
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Zip Code
22963
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Beckysue started following Dr. Michael Trahan - Online Support Group, Anyones Rings Too Big?, Approval Process Stories and and 5 others
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The letter from Aetna says I was denied because I don't have 2 yr history of 35 BMI and one of the listed medical issues. I just don't Understand we sent them records from 2010 of weight of 220 2011 and 2012 and between then and now the lowest I've been is 202. Currently 214 and 5'3". So BMI has not been under 35. Also sent them two years of bloodwork records showing pre diabetic glucose levels, high cholesterol. Now we need a peer to peer review and surgeon wants PCP to do it and PCP wants surgeon to do it. The nurse at the surgeons office doesnt understand why i was denied. She said the surgeon almost never does peer to peer review. PCP doesnt want to do it because he has never had a patient with lapband and has never donethis before. I just don't know it's driving me crazy!
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Beckysue started following highschoolskinney
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highschoolskinney started following Beckysue
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Jenndkopp good luck to you too. I'm hoping the peer to peer will work but don't know at this point. I went to the seminar in March of 2012 and have been work ( jumping threw hoops) for almost 9 months. It's just so upsetting. Keep me posted on your progress.
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We are waiting for the official letter from Aetna. Dr. Trahan's office called that's how we know I was denied. Nurse Lillian said as soon as we get the letter we will appeal with a peer to peer review. I'm trying not to loose hope.
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Thanks mzyunique1 I am going to appeal its just so frustrating. But I'm not giving up.
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Dr. Michael Trahan - Online Support Group
Beckysue replied to Roses4me's topic in General Weight Loss Surgery Discussions
Hi Bonnie Just wanted to drop you a note. The insurance denied me doctor's office heard from Aetna. I can't understand why I am 5'3" 215 pounds, pre diabetic, elevated blood pressure and high cholesterol . I did the six months and only lost a few pounds ( but didn't gain) and was denied. We are waiting for the letter to find out why so we can appeal it. I am heart broken and have been so upset since I heard. Dr. Trahans nurse told me not to give up hope so I'm trying not to. Hope things are going well on your journey. I'll let you know if we get the appeal. Becky -
Well the doctor's office heard from Aetna. I can't believe it but I was denied I am 5'3" 215 pounds, pre diabetic, elevated blood pressure and high cholesterol . I did the six ;month supervised and only lost a few pounds ( but didn't gain) and was denied. We are waiting for the letter to find out why so we can appeal it. I am heart broken and have been so upset since I heard.
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Well the doctor's office heard from Aetna. I can't believe it but I was denied I am 5'3" 215 pounds, pre diabetic, elevated blood pressure and high cholesterol . I did the six month supervised and only lost a few pounds ( but didn't gain) and was denied. We are waiting for the letter to find out why so we can appeal it. I am heart broken and have been so upset since I heard.
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CaGottaBand reacted to a post in a topic: Anyones Rings Too Big?
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A friend who lost 100 pounds wears her wedding rings on her middle finger. I asked her why not resize? She said it reminds her of her accomplishments every morning when she puts her rings on.
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Still waiting to hear from Aetna. Monday November 19th will be 14 business days since they got all my paper work so I expect to hear something then. IT'S STILL DRIVING ME CRAZY
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Still waiting to hear from Aetna they have had all my paperwork since Oct. 31st. It's driving me CRAZY ! Everytime I call they tell me it's still in review.
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I have not heard from Aetna yet I'm going to call in a little while to check the status.
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I called Aetna today ( paper sent to them on the 31st) its still in review. They said a nurse still has to look at it. They told me they have 14 days. So I guess I'll know by Tuesday.
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Thanks I'll call back Friday. I would be so upset if I got approved and had to wait till February.
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jms413 reacted to a post in a topic: I'm Approved
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I have Aetna and I have just finished the six month supervised weight loss. I am 5'3" and weigh 210 pounds I have pre diabetes, high cholesterol and slightly high blood pressure. I am waiting for Aetnas yeah or neah. Papers were submitted November 1st and insurance said it can take 7-14 days for answer.