I have just received my second denial in the mail yesterday. I was tring to find out if anybody could help me with my situation. Apparently I dont meet Aetna's criteria of bmi of 35 with one of the 4 ilnesses. I have copd, asthma, urinary stress incontinence, venous insufficiency and severe degenerative arthritis. I was hoping maybe you could let me know what to expect at the external review. :sad:ote=yayamama76;836848]It took my six months and 2 denials to get approved through Aetna. I finally ended up with a peer-to-peer arbitration between my surgeons office and Aetna. We won!
I was banded two weeks ago and I feel so fortunate! I'm on my way now.
Don't give up - if they tell you no, ask them what the next step is for you. If the procedure is DEFINITELY covered in your policy and you are sure the meet the quidelines = make them work.
Good luck!:tt1: