Dr. Terricina's office will file with Aetna tomorrow. His office says Aetna is really picky. They said it might take as long a 3 weeks for them to approve or deny. If they deny I don't know what I am going to do because I am a teacher and have to go back to school in mid to late August. I asked how long for an appeal and they said it depends on what Aetna thinks the problem is...a week to months... So now the wait begins... Everyone here has been through it so you all know the anxiety I am feeling... how do you get through this? the Dr.'s office did pencil me in on the surgery schedule in case they approve the first time around.

Khy

I will be crossing my fingers for you and hoping for a quick approval. Aetna is hit or miss on here, but we will just have to see where the chips fall. Did you meet all your requirements?

I have Aetna and it was much easier than I expected, especially going for a revision. Something I have learned though since I had to change surgeons after getting the approval once already for the revision is that it appears to me (this is just my opinion of course) that the offices that have routine difficulties with certain ins. companies may not fully understand the policy bulletin. For example, the 2nd surgeon I ended up going with for my surgery TOTALLY does not understand what the policy bulletin says. They couldn't believe I got approved so quickly without having to do this, that and the other. I explained to them that it is not required per the policy bulletin if you meet x, y, z criteria. In some ways, I'm glad I had already gotten the approval through the first surgeon because I think the 2nd surgeon's office would likely have really MUCKED things up for me.

So, I think it all comes down to how they approach the process. I'm not saying those offices are good or bad- just that some are better than others when it comes to those things.

The one thing i can tell you is provide them all the documentation you possibly can that justifies that this is a medically necessary procedure. I buried them with documentation!!! I was approved in 3 days the 1st time and 4 days again the 2nd time. The 2nd time they just used the first set of documents submitted, but still had to go through the formalities.

I wish you luck!

I have given them 5 years weight history... they ask for 2 but the Dr. office said better to give them 5. Had 3 appointments with the Nut. with one more scheduled in case they deny. They ask for 3 but sometimes deny if there is not 4. BMI is over 40. However, BMI has not been over 40 for 2 years. It has been around 39. Had the appointment with the psychologist. Had the EKG done. Paid for the required exercise class after surgery. I aksed my PCP for about referring me for the pain in my knees but she is against this surgery so ignored my request. So I think I hit all the requirements.

Khy

Good luck on a quick approval and date! I think alot of it is being proactive and calling your insurance yourself to be sure you understand all the guidelines they require. It breaks my heart when someone has been working toward the sleeve only to find out their insurance doesn't cover it.

my contact at Aetna says they have a 15 day turn-around.. I am in hurry up and wait mode too.. I wish my surgeons office would have penciled me in for a date... I am dying to know when this can happen so I can plan my vacation time... It's making me nuts. My advocate was on vacation and just came back on Monday so I called to see if she was able to send my paperwork to Aetna and she tells me the doc is on vacation and they are "trying" to get his password to get my letter... Ugh!!! Am afraid I will have to wait til he comes back. Good luck getting your approval quickly.