Oh my gosh...APPROVED! (After being told verbally I would be declined.)

[flmama 105]

My coordinator called in my info on Monday 3/4 and was verbally told I would be declined because I didn't have a 6 month physician supervised diet (after being told in January that my only requirement was to have "tried and failed" to lose weight). She raised a fuss and I raised a fuss and we went ahead and submitted everything anyway and I planned on using Lindstrom if I got an actual denial.

I called to check on it late last week and the nurses said it had actually been sent for a physician peer to peer review, which surprised me...I thought that was only for appeals, but she said the way THEY work (Aetna Signature Administrators...a self-funded plan being administered by a third party administrator) is that if the nurse can't say "yes", it automatically goes to peer review, because nurses can't determine medical necessity. So, I figured it was just delaying the inevitable "no."

I just got a call from the nurse, telling me that the physician director approved my surgery as medically necessary after speaking with my surgeon and PCP! Hooray! I can't wait for the coordinator to call me to schedule now.

[KimMarh 99]

Congrats.

[Lori228 60]

Good for you for sticking with it!! Good luck!

[Ms skinniness 3,003]

Can you see me dancin? Yayyyyyyyyyyyyy! Congrats! can't wait for you to join us on THE BIG LOSER'S BENCH!

[Jermiria LaideeJae Darden 17]

That is awesome!!!! Congrats to you! I wish you all the best!

[flmama 105]

Thanks y'all! I'm so excited and can't wait to be on the loser's bench!!!

[firelle 146]

Congrats!!

[flmama 105]

Surgery is officially scheduled for 4/11/13!

My pre-op diet should be "easy"...I am having oral surgery on 3/22 and won't be able to eat anyway for 7-10 (and won't want to if this one is the same as the last one I had). Hopefully I'll sleep through a good portion of the pre-op diet on pain meds!

[Amanda626 153]

Congrats!!!!!!!!!

[0tracy0 6]

Congrats. That gives me a little bit of hope. My doc has to do a peer to peer review with Aetna.