Waiting Game sucks... Anyone recently submit to Insurance?

[tgrow 6]

Yes, I've recently been approved (13 days from submitting). No surgery date yet

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[mrobles1027 7]

So Im a little sad that my request was partially approved. Aetna approved the removal of the Lap Band but not the sleeve. Spoke to my doctor's office and they said they will have my doctor to a Peer-to-Peer Appeal. So I wont know until maybe Wed or Thurs what the outcome of that is. I was so excited and looking forward to it to. I didnt really understand the reason for their denial either. They said I was non-compliant with the band because of my weight gain but dont see the issues I had with it. So heres hoping for the best.

[HuneComz 103]

@@jones6189 The length of the process is dependent on insurance. My insurance required a three month physician and dietician supervised diet. Some insurances require six months, some...in between. You should be able to research your insurance and find this info.

@@mrobles1027 So sorry! That stinks. I hope the appeal goes better for you.

[creatingthenewme 91]

My doctor submitted to insurance on 10/31 and it was approved on 11/04. I called at least twice of day and they told me on the 4th that it helped me in getting it approved faster. Good luck and I hope you receive your approval soon!

[mrobles1027 7]

My doctor submitted to insurance on 10/31 and it was approved on 11/04. I called at least twice of day and they told me on the 4th that it helped me in getting it approved faster. Good luck and I hope you receive your approval soon!

It was partially denied. The approved the removal of the band but not the sleeve. So Im waiting for my doctor to call in and do a peer to peer appeal. So hopefully I will know by Wednesday. Thank you!

[Aggiemae 739]

Finished the pre op class 10/4 , insurance submitted 10/5.. CPAP run around... pre op appt 10/20, surgery 10/25

[HuneComz 103]

I just got the call from my surgeon's office - Aetna approved by phone today. It went over Friday. Possible surgery date 11/29!

[mrobles1027 7]

I just got the call from my surgeon's office - Aetna approved by phone today. It went over Friday. Possible surgery date 11/29!

Congrats!!! Good luck and keep us posted.

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[mrobles1027 7]

I remember the waiting game for my band to sleeve revision. My bariatric center sent the paperwork in April, I was denied quickly because I had no medical issues, was lower bmi (due to band)... Etc. At that point, I was content to let my band rest since my band had been good to me (they unfilled my band for being too tight), and come back 3 months later to get it filled again. A month later or so, I get a call they approved me on second appeal... Then it got very real lol.

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How long was the whole process from your first visit to your surgery date? Do you have Aetna?

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[Sai 785]

I remember the waiting game for my band to sleeve revision. My bariatric center sent the paperwork in April, I was denied quickly because I had no medical issues, was lower bmi (due to band)... Etc. At that point, I was content to let my band rest since my band had been good to me (they unfilled my band for being too tight), and come back 3 months later to get it filled again. A month later or so, I get a call they approved me on second appeal... Then it got very real lol.

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How long was the whole process from your first visit to your surgery date? Do you have Aetna?

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April to September, about five months, beginning to end. I have Bcbs.

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[magnificent2015 34]

My claim was submitted on Friday 11/04. I'm currently still waiting on a response from the insurance. I had applied once before in June 2015 and was denied by my prior insurance because they required 12 months of nutritionist and doctors appointments and I only had 6 months. This is technically my 3rd time applying so hopefully I get approved this time.

The second time we had to withdraw it because even though they said 6 months of nutritionist visits, they still wanted 12 months of both. My old insurance was a joke. I started this whole process in February 2015. So fingers crossed this time.

Congratulations on the approval!!

Edited November 8, 2016 by magnificent2015

[MarcyDarcy 15]

I am getting a revision from lap band to sleeve. I got my lap band in 2010. Everything worked fine until I had minor complications almost a year later and after I had my daughter. So it really isnt working for me anymore. I have almost gained all my weight back. I look forward to my journey with my sleeve.

However, my doctor's office submitted my paperwork to Aetna on Oct 24 and still havent heard anything. Ive checked with the coordinator and Aetna and they just tell me its pending. Today is the 10th business day from when it was submitted. Aetna said additional information was submitted on 11/2 and told me to check on Monday.

Anyone else playing the waiting game? Im ready to get this party started lol

I'm in the same boat. My request for prior authorization was submitted on Oct. 24th and I've been waiting for the call ever since. I'm just trying to have patience and keep telling myself that it will happen as soon as it can and for now it's out of my control. It feels like agony waiting though, or like it might not really happen until I have the official surgery date.

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[mrobles1027 7]

I am getting a revision from lap band to sleeve. I got my lap band in 2010. Everything worked fine until I had minor complications almost a year later and after I had my daughter. So it really isnt working for me anymore. I have almost gained all my weight back. I look forward to my journey with my sleeve.

However, my doctor's office submitted my paperwork to Aetna on Oct 24 and still havent heard anything. Ive checked with the coordinator and Aetna and they just tell me its pending. Today is the 10th business day from when it was submitted. Aetna said additional information was submitted on 11/2 and told me to check on Monday.

Anyone else playing the waiting game? Im ready to get this party started lol

I'm in the same boat. My request for prior authorization was submitted on Oct. 24th and I've been waiting for the call ever since. I'm just trying to have patience and keep telling myself that it will happen as soon as it can and for now it's out of my control. It feels like agony waiting though, or like it might not really happen until I have the official surgery date.

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Thats how I feel. Have you called the insurance directly? Do you have Aetna? Im going to call my doctor tomorrow to find out about the appeal.

[MarcyDarcy 15]

I haven't called my insurance or the clinic yet. I'm almost afraid that they will have bad news, that I've been denied. I have Uniform Med Plan and Premera. I don't have any comorbidities, but I still feel like I've met all of the qualifications. I'm just hoping to have it done by the end of the year.

[mrobles1027 7]

I haven't called my insurance or the clinic yet. I'm almost afraid that they will have bad news, that I've been denied. I have Uniform Med Plan and Premera. I don't have any comorbidities, but I still feel like I've met all of the qualifications. I'm just hoping to have it done by the end of the year.

Same here. I want to get it done before the end of the year because my deductible is paid in full. If I get it done I will need to pay it again. Not only that I really just want to start the process already. I think you'll get good news. Give them a call.

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