lonestar5212

And they wonder why our brains explode by the time we hear whether we were approved or denied!! It seems as if everyone's process is painful. Hang in there, those before us suffered through the process, as we are now. At least you have approval! I envy you as I sit and wait for that. I was told by Aetna on Monday that I am in medical review. Okay, fine. Then I get a call from my surgery center Tues. telling me that they submitted my file to Aetna 2-12. I said "What?????? You told me on Jan. 28th that you submitted it that week. Then Aenta sent me a letter on 2-2 saying that docs were missing. I spoke to your ins. girl on 2-4 and she faxed them again to Aetna while I was on the phone on 2-4. Aetna gave me confirmation of receipt that same day. Then on 2-11 Aetna told me they received everything and that my case was in medical review. Given all this, how could you be saying that it just went today??!!!" Answer from her "I am confused to, but that is what it says here. You sound farther along so keep us posted." I hung up bewildered. And we are to trust all these other people with the most important thing in our lives. I feel your pain and frustration. You are almost there. We wish you the best with your surgery.

Five year history just doesn't seem to get to Aetna for alot of folks on the first try!! Hang in there. Keep calling your PCP and surgeon's office to make sure they sync up, and then call Aetna and make sure they have received everything. Whew, this is exhausting!

Thought I would share while I am on hold with Aetna. It is almost getting funny, all the bumps in the road I have. I have been on hold for about 10 minutes because the girl can't get her computer to move past the point where they see my info. Now she came back on to tell me that the computer finally moved and she can see that my case is still pending. But she says she can't see past that because our policy is handled by a "dedicated dept." that only handles claims from our company. So now I have hung up and called that number and am on hold again with them. I just want to make sure they aren't still missing any documentation that they said was missing last week. They received that stuff last Monday, so I am hoping that something else hasn't come up missing. Still holding----- Okay, nurse just came on and said that "all documentation has been received and it has been referred to the medical review staff." So, I am still pending and they have all the docs. So, back to waiting. Hang in there everyone else who is waiting. I feel your pain.

Finished all requirements for ins. on 1-21 File did not get sent to Aetna until 1-29 Letter from Aetna stating they didn't have all documentation on 2-2 (?) Made a million calls and got docs resent to Aetna 2-4 Still waiting to hear 2-8

Yeah, they do have the 30 days. It is so painfully hard to wait, I know, I am waiting also. And I lost a week because the center faxed my stuff on 1-29, but insurance said on 2-4 that they had not received all the documentation, so I had to make some calls and get it done again. Ins. acknowledged late on 2-4 that they did have everything. But I lost the week before because counting 30 days doesn't begin until ins. has all the documentation. Isn't this fun? I am now just trying to stay busy. Good luck to you and please post as soon as you hear.

Like I have said before, this shouldn't be this hard for us. It is horrendous. I am surprised half of us don't lose it before this is over. Congrats to you guys for getting your approvals. You are almost there. Hang in there, all of us are crossing our fingers that your mail holds good news today. Good luck.

My documentation was submitted by True Results last week. Today, Sat., I got a letter from Aetna telling me they need documentation of my three month supervised diet. How could that have not been sent? That was the whole purpose of my going to the center for three months, so that the three month documentation would exist. Why would it have not been sent? So, because it is Sat., I get to live with this until 8am on Monday. Who should I call first, Aetna or True Results??

I thought of that the other day and double checked the number it should have went to and checked to see what number it WAS faxed to. The numbers matched. Aetna apologized and said they don't know why this kind of thing happens, but it does sometimes. At any rate, just waiting for an answer now.

I got a call from Aetna around 3:00 letting me know that they do indeed have the fax and the documents now. I am thinking you are right on about the letter. It could be standard operating procedure as soon as they receive the request. I have just never had to deal with insurance before regarding precertification, except for dental. Now the wait begins. I wonder if they will call me or if I will get a letter letting me know approval or denial?

I got in touch with Aetna this morning and was told that they did not have my stuff. I called True Results, and they couldn't have been nicer in the insurance dept.. They said they faxed 43 pages to Aetna last week. I called Aetna back (they were nice to me also), and they suggested I have True Results fax it over again. I did just that, and True Results was very cooperative and reacted quickly, faxing while I was on the phone with them. They called me back a short time ago to let me know that they received confirmation from Aetna of receiving the documentation. I will be calling Aetna this afternoon, just to hear with my own ears that they indeed have everything they need to make a decision. I now see why everyone says to call, and call and call. I will keep you posted on the progress.

I talked to Aetna this morning and they said that they did not receive my documentation, just like the letter stated. So I called the center and talked to the insurance girl submitting my stuff, and she said she faxed all 43 pages last week. So I called Aetna back and they said to have it faxed again. I called my center and had them fax it again. About 30 minutes again my surgery center phoned to tell me that they received confirmation from Aetna that it was received. I am also going to call Aetna after lunch and verify that they now have it. Aetna and my surgery center were both very cooperative once I was able to get human beings to talk to. Hopefully, when I call this afternoon they will confirm receipt of documentation and this moves forward. Now I just have to hope I don't get denied.

tmarie07 Thank you so much for your reply. It made me calm down alot. I will call Aetna at 8Am on Monday, as well as True Results and hopefully get it all straightened out. Thanks again, it meant alot to me to be able to see that someone else had the same thing happen.

After checking the mail today, I received a letter from Aetna stating that they needed my five year history and documentation of my 3 month supervised diet. I am pretty confused. I know True Results had everything, they went over it with me last Monday before they sent it. So why did it not go to Aetna? And now, because it is Sat. I have to wait until Monday to get any answers. I think I will go throw up now, I am just sick.

I already left the girl who is handling my case at True Results a message, and I will be calling first thing Monday. I am so mad. I trusted that they would get this process right since they have done it a million times. I am also going to call Aetna and let them know that I gave everything they are asking for to True Results who told me last Monday that everything would be sent to Aetna. I can't believe I have to wait til MOnday, I am shaking I am so upset.

We are all so happy for you. I am glad you didn't have to wait long. I am also going through my husband's insurance with Aetna from the company he is retired from now. Hopefully, it will move fast as well. I also wonder if the retired medical is handled by a different area. I don't know, I am just glad we have it! Good luck with your surgery and your new life to come, healthier and happier!!!!

SpecialK Your paperwork and my paperwork got to Aetna at the same time! I got the 30 day answer also. I was very impressed with the 3 day answer some were lucky to get, but I told myself it would probably take at least 2 weeks. That way I won't lose my mind until then!! I am trying so hard to stay calm. Good luck to you, and I will be waiting to see your post letting us all know you have received approval! Hang in there, this too shall pass, and we will be on our way.

About 4 years ago my daughter had surgery, not lapband, but we had the same thing happen with the anethesiologist's charges. I simply called them and said, just what you said outloud. If you approve the surgery, and the surgery center, how in the world would I know that the anthesiologist would not be to your liking? They told me I would not have to pay it. It was Aetna POS II. Also, I used a surgeon in the same practice with Dr. Marsden (he left that practice last July to focus on lapband), but he had an excellent reputation here in town, and with my friend who was a nurse at the hospital where Dr. Marsden worked at the time. She gave me an excellent report on him. So I feel very comfortable with my choice of him for my lapband surgery. My paperwork submitted to Aetna this week, so I am waiting to hear.

dwh - You got approval in three days? Fantastic!! True Results was submitting my stuff to Aetna "this week." Not sure what day. I am on pins and needles. Congratulations to you and your wife. Best wishes on the surgery.

Could you please share with us what they messed up? My center just submitted for me and I am so nervous about this process being in someone elses' hands besides mine. Thanks.

I had my last appt. of my supervised diet last Monday. I got a call this morning saying that my file was now complete and they would be submitting to Aetna this week. I have Aetna Pos II. I will keep all you Aetna people posted as to what happens next.

Thanks for the suggestion, that is exactly what my husband proposed last night. That is exactly what I plan to do today. Thanks guys for responding and giving me the push I needed to do it.

God, why is this so hard??!!! I just want to scream. My surgery center is ready to submit all my stuff, but can't because we can't get a report faxed over from the nutritionist. I called her early this morning and the center called her as well, her response was, "she is on my list of stuff to fax." Period, that is it. When she gets around to it, it will get done basically. Keep in mind that my last visit with her was Jan. 9th. Surely there was time to fax sometime between the 9th and today. I am so frustrated with this process.

I had my last appt. of my supervised diet today. Yeah for that!! However, I was told that the nutritionist did not fax over a report from my visits with her, nor did they have the fax from the sleep study lab of my second visit with them. Therefore, they could not submit to insurance until they received those. I called the nutritionist and the sleep study lab as soon as I left to fax those missing items over. They both said they had already done so, but would do again. Therefore, I left without even knowing exactly when they are submitting. I told them I will call in a day or so to make sure they have submitted so I can keep track of when Aetna receives it so I can call them everyday about approval. This is the most frustrating thing I have gone through in a very long time. People just don't seem to get how important this is to do everything in a timely manner. I am on pins and needles since this all started, and it really doesn't seem like anyone really cares. I think I am going to go have a breakdown now-------

kimillionaire I will let everyone know as soon as I know, for sure. I only have one more day after today on the supervised diet. I go Monday for my final visit and then they will submit to Aetna. I am excited and scared at the same time. I will be so sad if I get denied. But I am trying to think positive about approval. Will know soon and will let you know how it goes.

hey greeneyez, congrats on your surgery. Glad you are doing well. Hoping to have my surgery next month, we will see what ins. says pretty soon. Keep us posted on your progress, best wishes. P.S. I am watching the Australian Open as we speak!!