JaysWife

I just went back through all of my available medical history and found what I would consider to be the documentation. I have weights from every visit from the last 3 years, and all of the notes from my nut. Now I just know is I should appeal or just resubmit...

Just got denied again. They said it's the same reason as before. Lack of information. No documentation of 6 months supervised weightloss program and no documentation of 24 month history of obesity. All of which my desk office says they sent. I'm waiting to hear back from the nn to see what can be done but I'm afraid this may be the end of my journey...

For the second time now I've been denied by Aetna. Their reasoning is lack of information. I started my whole journey at the of July/beginning of Aug. 2020. I did the required 12 classes as fast as they could send them to me, which at the time was acceptable. Had all the testing and everything done by end of Sept or there abouts. My hospitals insurance team got everything together and sent it to insurance and they denied it stating the didn't receive 6 months of dr supervised classes nor 24 months of documented obesity. So my Dr tacked on 4 months of classes one class a month and the nn said they would go to my previous provider for the weight history. Fast forward to now, I have completed everything and have a tentative surgery date of March 22nd. Tomorrow is to be my pre-op appointment but I found out today that my insurance denied it AGAIN. Saying the exact same reasons are the cause. I'm devasted. I've been working so hard. I've been hungry for days. Fighting off the emotional eating and sweets that I crave so badly for something that I feel like will never happen. I can't afford to self pay. I feel like this is the end for me.

I started my whole journey in August 2020. I did 12 virtual classes as fast as they could get them out to me. My case was submitted to insurance with all of the required info at the Beginning of Nov. for a tentative Dec. surgery. It came back a week later denied stating that I hadn't completed 6 months of a supervised weight management program and they didn't send 24 months of documented obesity. (I've been obese since I was a very young child) So my nut. added on 4 more months of classes which I finished the first week of Feb. my claim was again submitted with all required info for a March 22 surgery date. I called today to check the status and once again was denied with the same thing being the cause again. I am at a loss of what Aetna wants because my surgeons office says they sent it all. All I know is I am devastated right now.

It really is a whole mess to deal with, right? Ugh, fingers and toes crossed for you too!

Congrats!!! How is the healing? Is it painful afterwards?

Hi everyone, I've been here for a while but never posted before. But I'm just under 3 weeks away from my surgery. My nerves are going crazy. I don't know if it's because of not having my approval from insurance yet or about the actual surgery. I was denied back in December and it was so disheartening. But my Nut. and NN have helped me make sure all requirements are met this time since they were changed part way through so my fingers are crossed. How do/did you guys get passed the jitters? I feel like literally all I do is worry about weightloss and meal planning to the point that I'm not sleeping...

March 22nd here if my insurance approves me this time ? last time they changed their policy part way through the process and denied me.

Have my tentative date of 12/9. Got my last pre-op visit scheduled for 2 days from now. I'm still waiting on my insurance to approve me tho. I'm so nervous because they haven't yet. My nurse navigator says not to worry, that they will get the approval, but I just can't help it. Until I get that approval and actually have that surgery I am going to be a bundle of nerves, convinced my surgery is going to be cancelled or postponed... it doesn't help that I'm currently horribly bloated and retaining fluid from that lovely woman time. So I'm also terrified that water weight gain is going to disqualify me... Ugh what an emotional roller coaster this journey is.