Red_lips_and_confidence 148 Posted May 22, 2013 Thanks soul :-/ I think something got screwed up because I did everything on the list and the hospital said they received all documents and submitted but according to my insurance I didn't!?? It's mind boggling I don't get it? We're gonna get to the bottom of it .. So aggravating !! Just more freaking hoops to jump through, I'm sure they hope I accept the denial and leave it at that but heck no there will be blood were fighting this! And if it wasn't meant I'm just gonna have to accept that it wasn't gods plan and well idk what I'm going to do uhg 1 southernsoul reacted to this Share this post Link to post Share on other sites
Sab964 10 Posted May 22, 2013 Get em girl! Insurance companies want you to give in and give up but I'm glad you're not!! I made sure with my insurance every single form/paper they wanted and I made sure I had copies of each, my surgeons insurance ladies (while VERY nice) could be forgetful... I wasn't having any of that... 1 Red_lips_and_confidence reacted to this Share this post Link to post Share on other sites
southernsoul 773 Posted May 22, 2013 Hang in there, baby girl. It's probably just a form or letter that got missed or misdirected somehow. Aetna denied my psych's claim for my testing & sent me a letter telling me she was not allowed to bill me for the cost. Turns out she just had to re-submit claim with a different code. I'll bet your denial is due to something simple & fixable. Take a deep breath & hit it again tomorrow. 1 Red_lips_and_confidence reacted to this Share this post Link to post Share on other sites
LisaLoseAlotx2 147 Posted May 22, 2013 They said I haven't been obese for more then two years which is BULL I've never in my life been under 240-278 for the past 6 years ad they said I never completed a 6 month diet dietician thing when the insurance coordinator for Aetna gave me a 3 month diet dietician thing with physicals and clearance from doctors and psychiatrists I did everything they told me to and they are saying I didn't I'm SO mad I'm at a loss for words There are no words to explain how sad I am for how you are feeling. This too shall pass. This is also 90% of why many of us go to Mexico...myself included. I was told that I had not been "obese" long enough to qualify, after going through 6 months of testing (metabolic and otherwise). Insurance companies in the US will say and do anything to deny, deny, deny. You have options. I wish you the best and do not give up!! 1 Red_lips_and_confidence reacted to this Share this post Link to post Share on other sites
Annie04 28 Posted May 22, 2013 So sorry to hear about that, I have heard though that they deny most of the time hoping you will just dismiss it. Most people that have the surgery have gone through an appeal or two. If you have the documentation and have gone through their "hoops" you should have no problem. I also have Aetna, and my plan does cover bariatric surgery, but only at 50 percent. I decided at that rate, I would just go to Mexico and have it done on my terms. I researched and found a very reputable doctor and it is costing me less than $5,000. I figure that I will see that back in a couple of years just by eating less and eliminating some of my health problems. Don't let these people define what you know is best for you. If you really want this, you will find a way!! I am sending positive thoughts your way!! 1 Red_lips_and_confidence reacted to this Share this post Link to post Share on other sites
QueenAmandy 5 Posted May 22, 2013 Hang in there, I was denied 2x and it didn't really take that long to appeal.. the girl doing the paperwork in my surgeons office was helpful but I think was missing something - it took the nurse in my surgeons office to set up a conference with my insurance to go over all my medical records to only discover it was a miscommunication somewhere .... I so know how you feel but don't let it get you down - just stay on top of everything and everyone to make sure they do their part. 1 Red_lips_and_confidence reacted to this Share this post Link to post Share on other sites
naroby80 17 Posted May 22, 2013 Sorry if you were offended. I wish you luck but everything I said was true. Getting denied by your insurance was not a political issue...it was a paper work issue. The world is always looking for someone to blame. Just check yourself. Again Good luck! Share this post Link to post Share on other sites
JProx 161 Posted May 22, 2013 A lot of people go through this, keep your head up and reapply a soon as possible . God Bless and Prayers. 1 Red_lips_and_confidence reacted to this Share this post Link to post Share on other sites
lexi6510 56 Posted May 22, 2013 They said I haven't been obese for more then two years which is BULL I've never in my life been under 240-278 for the past 6 years ad they said I never completed a 6 month diet dietician thing when the insurance coordinator for Aetna gave me a 3 month diet dietician thing with physicals and clearance from doctors and psychiatrists I did everything they told me to and they are saying I didn't I'm SO mad I'm at a loss for words How much is the surgery where you're from if you pay cash?? I paid $10, 000 cash and it was done. Cheapest around my area and no hospital stay. Share this post Link to post Share on other sites
Red_lips_and_confidence 148 Posted May 22, 2013 My mom is working it out as we speak so fingers crossed! And I have the BEST Aetna coverage of all the plans and its a $25,000 surgery and we only pay $800-$1000 out of pocket. Thanks everyone! In trying to stay hopeful and positive Share this post Link to post Share on other sites
perezjewels 1 Posted May 22, 2013 Hey I'm new to this site trying to figure it out but I have aetna as well after four denials I was approved .Just let the Lord control your life. And keep appealing. Wish u the best:) 1 Red_lips_and_confidence reacted to this Share this post Link to post Share on other sites
Red_lips_and_confidence 148 Posted May 22, 2013 Hey I'm new to this site trying to figure it out but I have aetna as well after four denials I was approved .Just let the Lord control your life. And keep appealing. Wish u the best:) I don't understand why the heck Aetna is doing this and being SO difficult ! My surgeon actually said he has never seen something so ridiculous before in his career dealing with insurance companies its the first time he's seen this happen Im like GO FIGURE!!! My luck! So now I have to get as many doc letters as I can.... Perezjewels what was the reason for denial??? What did you do and how long ago was this!?! Share this post Link to post Share on other sites