treequeen 13 Posted July 1, 2011 So today I got a call from my advocate from the surgeons office. She didn't leave a message and was gone by time I got off work...I'm thinking it was to schedule a date cause when I got home there was an e-mail from my aetna contact who said all was well with the paperwork and I'm approved for the sleeve and 1 bed day in the hospital...That took the joy and turned it to worry because my surgeon requires a 3 day hospital stay. He likes for the swelling to go down significantly before doing a leak test which is the reason for the long stay. Now I'm afraid if I have to pay for 2 extra days myself I will have to keep saving and by the time I have enough, my approval will have expired and I'll have to start all over again. Share this post Link to post Share on other sites
AutumnBlueCarmen 4 Posted July 1, 2011 I hope you can find a good option. I wonder if your surgeon could arrange something where you can come back. I hope you can make a deal! Good Luck! Try not to worry too much! Share this post Link to post Share on other sites
Maddie 9 Posted July 1, 2011 I agree, I would see if the surgeon's office could coordinate things since it's his idea that is changing the dynamics of things. It's also only your surgeon that could possibly convince the ins to pay for the additional days. Just keep jumping through those hoops, you'll land on your feet. Share this post Link to post Share on other sites
PeteO 3 Posted July 1, 2011 So today I got a call from my advocate from the surgeons office. She didn't leave a message and was gone by time I got off work...I'm thinking it was to schedule a date cause when I got home there was an e-mail from my aetna contact who said all was well with the paperwork and I'm approved for the sleeve and 1 bed day in the hospital...That took the joy and turned it to worry because my surgeon requires a 3 day hospital stay. He likes for the swelling to go down significantly before doing a leak test which is the reason for the long stay. Now I'm afraid if I have to pay for 2 extra days myself I will have to keep saving and by the time I have enough, my approval will have expired and I'll have to start all over again. Talk to your advocate about this. My surgeon's office told me that my insurance plan only covers a 24 hour observation period, but that is flipped into a 2-3 day stay based on the doctor's assessment during the observation period. It is all a cat and mouse game. -Pete Share this post Link to post Share on other sites
former_vbg 198 Posted July 1, 2011 Talk to your advocate about this. My surgeon's office told me that my insurance plan only covers a 24 hour observation period, but that is flipped into a 2-3 day stay based on the doctor's assessment during the observation period. It is all a cat and mouse game. -Pete Ditto. I was only approved for a one night stay, but stayed 2 nights due to the fact that I was I had not passed gas or had a stool yet. That was enough for them to put in a diagnosis code to support the stay. They were possibly not even going to release me the next day because I wasn't drinking enough fluids. I was so ready to leave though. I did not like Forest Park, their staff was VERY inconsistent with care. But, you might also see if you can come back for the leak test too. Especially if you feel like leaving after the first day. Share this post Link to post Share on other sites
treequeen 13 Posted July 2, 2011 All is well in my world again! Advocate said that it is the standard initial approval from the insurance... and I have nothing to worry about.. And even better, she told me my out of pocket is $300 less than I thought it would be!!! Now I just have to wait for the scheduler to call me next week. Yippie! Thanks for the support everyone. Share this post Link to post Share on other sites
sunnyd 32 Posted July 2, 2011 Thats's great news for you! Woo Hoo! Good luck to you as you get your date and surgery! Share this post Link to post Share on other sites
AwesomeSleeve 5 Posted July 2, 2011 Congratulations on your approval and I'm happy everything worked out for you. Good reason to Celebrate this weekend. All is well in my world again! Advocate said that it is the standard initial approval from the insurance... and I have nothing to worry about.. And even better, she told me my out of pocket is $300 less than I thought it would be!!! Now I just have to wait for the scheduler to call me next week. Yippie! Thanks for the support everyone. Share this post Link to post Share on other sites
1tracy 1 Posted July 2, 2011 Just had to say congratulations and I am so glad it has all came together! Wishing you the best! Share this post Link to post Share on other sites