Aetna POSII

Flowerpurr · May 21, 2008

Hello Everyone,

I need to know if anyone else is having this problem with Aetna. I call the customer service they say my file is assigned to a nurse I call the pre-cert dept and they say it's on hold due to not information. My question is to everyone have you had this happen conflicting stories? Plus the nurse at my Dr.'s office said she doesn't need to submit the three month diet I did with all the notes she said all they need is a summary? Is this true? What did everyone submit? I am so fustrated I could scream. I waited three weeks for the Dr.'s office to submit now you are telling me they didn't get it right? Please someone help! I don't want to get denied because of some stupid nurse.

ndwife · May 22, 2008

Wow- sorry to hear that you are having so many problems. I started my journey later than you and I am getting banded on 5/28. I do have the same insurance and I turned in all of my doctors notes and nutritionist notes for the 3 months. I also had a letter from the PCP and doctors notes on weight loss from my endocronologist and obgyn.

The more info the better. My info was sent on 5/5 and received my approval on 5/12. I received my surgery date yesterday.

Good luck with getting through to your doctors office. You do not want to have to deal with an appeal.

Flowerpurr · May 22, 2008

Well thank you and congratulations on your approval. I called Aetna this morning and they said it moved into the decision area. So hopefully I will know in the next couple of days. My Dr.'s office swears they sent Aetna everything they need. If I get denied because they didn't than I am going to pull all my records and go to another Dr. But I have a feeling I will get approved. I have jumped through every hoop and than some. I have letters of medical necessity from six Dr.'s. How can they argue with that? Plus I did what they said on the three month diet and than some. I check in every week with a diet place. Where I saw a ditecian, exercise psychologist, behaivor modificiation specalist, and a Dr. weekly! Plus I checked in with my PCP every month as well. Sooo I did it all. My bmi is 43 so I qualify since I have no co-morbities. So I am praying that I here it's been approved! Let me know how you feel after your surgery.