mrobles1027

I was given a partial approval to my pre-authorization today. I was approved to remove the band but denied sleeve. Doctor is going to do a peer-to-peer appeal this week so Im hoping to get good news. Ive had so many complications with the band that is just stop working for me.

It took me a year to fight through the insurance douchebaggery and actually go under the knife. I even had to switch surgeons because my original surgeon's office staff was so completely incompetent that they screwed up not just my paperwork but dozens of other sets as well. The office manager was even fired and when all of this was explained to my insurance company they said:
"Oh... wow. Ok, look me just need 5 minutes on the phone with the surgeon to verify that."
He refused.
He. f**king. Refused.

So, yeah, I ended up having my surgery 9 months later than I wanted, but I'm incredibly pleased with the surgeon I went with, his staff, and the facility where I had my surgery. Getting denied can be crushing, but stick with it. Stay on the diet, keep doing everything you're doing in preparation for the surgery. If nothing else, you'll just lose MORE weight and be closer to your goal! You got this, lady!
Oh, and all said and done, the bill was like $45,000 or so. I paid $2500. Insurance! Wootwoot!

I was one week into my pre-op diet with surgery set for 11/15. Everything was going great and I was so excited to finally be getting there. Then I got a call Tuesday from my surgeon's office that my insurance denied me and my surgery was cancelled. They will help me start the appeal process but to be in the middle of my pre-op diet and so close to surgery and have it all just stop is heartbreaking.
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I was given a partial approval to my pre-authorization today. I was approved to remove the band but denied sleeve. Doctor is going to do a peer-to-peer appeal this week so Im hoping to get good news. Ive had so many complications with the band that is just stop working for me.

So sorry to hear about your denial. Hope everything works out. Keep us updated. Sent from Dee~Dee via BariatricPal

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!

I was given a partial approval to my pre-authorization today. I was approved to remove the band but denied sleeve. Doctor is going to do a peer-to-peer appeal this week so Im hoping to get good news. Ive had so many complications with the band that is just stop working for me.

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!!

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

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

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!

@@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.

Oh bummer. Well at least it's still in process. I'm sorry to hear that. You should call Aetna directly on Monday just to make sure they have everything. I've called them twice this week.
Yes I hope Aetna delivers good news next week. Please let me know as well when they tell you.
My only qualifier is my BMI and having complications with my band. So we'll see.

My band removal was approved on Friday afternoon! Woohoo! Of course, I wish we were doing the removal and sleeving at the same time, but my doctor would like me to wait 3 months before being sleeved.

That's good to know. My doctors office said that they got a denial for someone who didn't lose weight in the 6 Month diet. Keep me posted!

My office was great they submitted it and called me three days later with approval. Wish u guys the best of luck!!!
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I was submitted to AETNA on the 14th called a few dys later and thry told me they received the request but no clinical ingormation. Called my doc and tbey resubmitted the clinicals on the 24th and received approval the 31st. My surgery is on the 23rd of November. I suggest calling member services and requesting status and any notes made so far in case you have an issue like mine.
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