Aetna 5 year problem.. and appeal advice?

[dogluvr 1]

This is my issue..... I switched doctors a year and a half ago.. the old clinic I used to go to, I would always 'opt out' of being weighed because I was so embarrassed about the skinny little nurse seeing my weight. So Im not sure if I can provide proof of being so heavy for so long :c(. I stopped letting them weigh me. Am I screwed? The woman in insurance coordination says that if Aetna denies me, they have a lawyer that for 1100$ will take the case and run with it. Has anyone with Aetna been denied and then had their appeal overturned? I want this so bad and will be devastated if I cant get banded because I had such low self esteem those years ago. :help:

[Dave01 0]

I fought with Aetna for about 6 months, after turning in all required paperwork. They are the worse to get approval from. My surgeon, primary dr and myself called them over and over to get it done. Each time they would require another thing. I cannot speak for every case, but with my experiences, without ALL of the required things, they will NOT approve someone. We had to threaten to take them to the insurance commisioner here in Florida to get approval. I hope you are luckier than I was and it goes easier...Dave

[dogluvr 1]

thanks for the input... the insurance coordinator is optimistic about the outcome, but we'll see!

[Sue Magoo 71]

Dogluvr:

Ask the doctor's office that you go to for a copy of your file. The doctor has probably written notes in the file about your obesity problem and the notes probably have dates with them. If not, shame on your doctor!

Good luck.

Sue