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Aetna Insurance

I am starting to get a little concerned. Aetna has had my paperwork for a full week now and I still have not heard from them if I have been approved. I've watched some of the dates of others on this site and some were approved by Aetna within 3 days. Is there anything that I can do to "push" the process along or should I just patiently wait for the answer?

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Aw, I am so sorry. I hope you hear good news from them soon! Keep positive!

I am starting to get a little concerned. Aetna has had my paperwork for a full week now and I still have not heard from them if I have been approved. I've watched some of the dates of others on this site and some were approved by Aetna within 3 days. Is there anything that I can do to "push" the process along or should I just patiently wait for the answer?

Be patient. I have Aetna also, and although mine was approved in just a tad under 3 days, I was sure to "bury" them with documentation. You can call their customer service to find out the status and they will tell you. I actually called myself to do that and actually found out 3 hours before my surgeon's office that I was approved because they hadn't sent them the approval yet (was in process). You can imagine how excited I was.

Do call them, be polite and just ask them if they see any notes in the file like missing documentation or something. I was also told that the closer it gets to summer the longer it can take because more people are taking vacation which equals a shorter amount of staff to process the pre-certs.

Good luck!

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I called this morning to check on the status of my request and was told that my file was still being reviewed. Later, I got a message to call the Aetna nurse. She said that I was approved but they were just waiting for a date from the Dr. office. Yeh!!!!!

  • 2 weeks later...

I called this morning to check on the status of my request and was told that my file was still being reviewed. Later, I got a message to call the Aetna nurse. She said that I was approved but they were just waiting for a date from the Dr. office. Yeh!!!!!

Congratulations, I hope your surgery went well. Aetna turned me down and it has taken me 5 months so far to try to get enough paperwork together to try again. I am so depressed!

a week would be great.. my aetna rep told me there is a 15 day turn-around doubt that counts weekend days. She told me to contact her when the docs office sends the paperwork so she can keep an eye out for it.. not sure how that will help but I hope it does. Just another month and a half of supervised diet yeah!

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Yes, I had to satisfy the 3 month dieting plan and lose 30 lbs before they would submit my paperwork. I did it. It seemed like it took forever but I did it. Now just waiting for the actual surgery two weeks from today.

Yes, I had to satisfy the 3 month dieting plan and lose 30 lbs before they would submit my paperwork. I did it. It seemed like it took forever but I did it. Now just waiting for the actual surgery two weeks from today.

Congratulations Nraeh. You will be in our prayers for a speedy recovery.

I was exactly 1 week away from my gastric sleeve surgery date and the bariatric center called me and said my insurance (Aetna QPOS) denied me the procedure. They have a ton of requirements to qualify for surgery, 1 being 6 months of doctor visits, 2 years of weight loss history and what they told me was that because I was not over 40 bmi for the past 2 years that it wouldn't be approved. What a punch in the gut that was. Of course, my surgeon is out of the country on vacation so he can not call prior to next week - so surgery put on hold. I called the insurance company and they said the doctor had to do a "peer to peer" consultation, the surgeon and the medical director at Aetna. This is a phone call to explain why the surgeon thinks I should have the surgery. If all goes well (please cross your fingers for me) then they will be able to reschedule my surgery asap. If not - then the appeal process begins. I am hoping this is not the case, but I can only play this by ear for now.

I never knew that being a "healthy" obese person could work against you, but since I don't have any co-morbid problems like diabetes or high blood pressure - they have to hope that my history with PCOS (Polycyctic ovaries) or a family history of high blood pressure and diabetes will work to my advantage.

If you pray - could you send one up for me???

Thanks!

Congratulations, I hope your surgery went well. Aetna turned me down and it has taken me 5 months so far to try to get enough paperwork together to try again. I am so depressed!

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