Kerra

I am gutted
I had my surgery back in April, and couldn't be happier. In fact, my husband is scheduled for surgery on Monday 7/30.
Well, anyways, the center KNEW from the beginning that he did not have a 2 yr weight history, which is required by Aetna. They told him that they have ways around that one and not to worry. Got a denial letter two weeks back and was told "don't worry- surgeon will do a peer review and they very rarely deny them." this was all from the insurance coordinator at the center.
He went in to sign preop forms today. He asked the surgeon if it was taken care of. He was shocked to hear this- said he was not notified by said insurance lady, and that he would have a word with her and get it done today.
Well, afternoon rolls around and he gets a call from the insurance lady from the center. Peer review was a fail and she told him to start getting his weight documented and to come back and see them in two years!!!!! I am absolutely disgusted with how unprofessional she had been throughout his whole process.
We are out about $1200 from co pays, deductibles, co insurance, time off from work, etc for him to be a part of the program. I am beyond pissed off- his leave was already submitted for work, etc. Who does the insurance coordinator think she is? Lying and then forgetting to mention to the surgeon of the issues?
My question for you guys- anyone ever been denied from Aetna for not having a clinically documented weight history, proving obesity for two years? They will not accept his records from 2007&2008. Wondering if there truly is a way around it like we were told in the beginning? If so, what did you do?
We have submitted an appeal directly with the insurance company as we feel we cannot be bothered with the insurance coordinator at the center any more. But that a) will take 30-45 days; will most likey be denied.

Just found out Aetna approved me! Keep trying!!!

I am scheduled for April 23 and feel the same way. I felt the same when I had my first child too, but there was NO turning back there! I have to tell myself the same with the band. I WANT to lose weight to be able to do more with my kids. I NEED to get my blood sugar under control. I HAVE to do this for not only myself, but for my hubby and kids. It is no longer an option. I am DETERMINED to lose this excess weight and I need this tool to help me make that happen
Oh, and anyone know how to get to the Springers group from the iPhone app?

Hey Jim! I think I know you... Same post on the LGH site I think we are the only ones active over there. Lol they will get it straightened out. I am sure of it!