Have band need revision to sleeve and have questions about Aetna approval process

amm1211 · May 10, 2010

I have had my band for 2 years which was self pay and am needing a revision to a sleeve and now I have Aetna. I had my sleep study last week with no sleep apnea and my endoscopy last week with Dr. Kim, he said I have a slipped band which has been empty for weeks. His office submitted everything to the insurance today and said we will have to wait to hear from them. Has anybody else gone throught these steps with insurance, how long does it usually take to get an approval or denial?

mrlddst · May 19, 2010

I posted a reply to your message over on OH. I was just approved for a revision to the sleeve yesterday. They submitted the paperwork in April but it was sitting in Aetna's queue with no case number so I called and withing 24hrs I got a call from my dr's office saying that I was approved.

amm1211 · May 19, 2010

I just so your post on there...congrats to you! I got approved too! I can have the band out now and have to do the 3 nutritional classes to get the sleeve so I am going to try and wait and do it all at once...hopefully end of July. Keep me posted on you!

dbernier01 · June 14, 2010

I just so your post on there...congrats to you! I got approved too! I can have the band out now and have to do the 3 nutritional classes to get the sleeve so I am going to try and wait and do it all at once...hopefully end of July. Keep me posted on you!

Hi -- to both of you who have a band and Aetna approved to revision to sleeve -- what did the doc sumbit -- just that you had a slip

I see my doc in 3 weeks -- going to get the upper GI soon so I can have that info with me when I meet with Doc.

I don't know if I have a slip -- but I can eat and eat -- yes random restriction then major stuck/slime, other times open flow --- I hate this band.

mrlddst · June 23, 2010

I'm not actually sure what they submitted. I was told by my doctors office that it was at the suggestion of an Aetna nurse that they send in for a letter of predetermination. They said they just faxed over my medical history. Two weeks later, I had an approval letter. They couldn't have sent over my nutrionist and pcp notes because I hadn't completed the 3 mos yet.