Filing through two offices?

brighterDaze · January 31, 2011

I work for a hospital system. I began my 6 month requirement for Aetna while working with a surgeon (#1) that's associated with my hospital system. The reviews for him say he's an excellent surgeon but a major a*hole and very unkind and unforgiving. As of January 1, another surgeon (#2) who everyone really loves in my area showed up as covered on my plan so I have filed my paperwork through Aetna through her office once I completed my 6 month requirements.

My delimma is this...I was told by the patient advocate that typically at surgeon #2's office that Aetna typically only approves for their office to do RNYs on employees at my company. My guess is this is because my hospital is affliated with surgeon #1 who used to do RNYs, but now only does lapbands and VSGs. The patient advocate has asked me to give her until Friday to determine whether my insurance will actually cover all of the cost of the sleeve. I'm thinking of going ahead and fiing with surgeon #1's office to see if this surgeon can get approval for the sleeve. It's in my policy that it's covered.

Does anyone think this could cause a conflict with me being approved if office #2 gets the green light while I'm working with office #1? I've waited so long and office #2 has been working on my paperwork for over a week now. I've been hoping to have this done in April. Am I doing too much?

leeblewb · February 3, 2011

Your insurance will probably only approve for one or the other. My fear if it was me would be it slowing the process down if they flag it or something.