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Aetna approved my surgery, was sleeved on 9/14 and now they are saying not approved???



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So I got my approval letter in the mail on August 5th. My nurse received hers electronically along with my precert number. I was sleeved on Sept. 14th and sent home after 4 days in the hospital due to some complications.

Today at my 3 week follow up, my nurse tells me that she has been arguing with my insurance company for 2 weeks now saying that they called her while I was in the hospital saying that my surgery was never approved due to no record of precertification. How can they say that when we have approval letters and a precert number and all forms regarding that are filled out and were submitted and approved? She showed them to me today and all the papers and emails that Aetna has sent her and all say approved on them.

I am wondering if because the total of my surgery including dr fee, anesthesia, hospital room, drugs, ct scan, etc comes to a little over $70,000??? are they trying to buy time to see how much they actually will pay??

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so did this get resolved??? That's a scary thing right there! Obviously, they weren't too worried about it getting fixed if they waited for your 3 week followup to even mention it to you - just hope everything got taken care of!

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$70,000??? Wow! I could understand why Aetna is so upset. Sounds like the medical industry is ripping someone off.

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