Hey everyone! It has been a while since I've posted but the real world has been crazy insane recently! So, I am done my three-months PSWL and all my ducks are in order to submit for approval except for one. I went to my PCP for my letter. The FIRST visit she was all "i need all of your records from the surgeons office before i'll consider it". SO, I had all my stuff faxed over and I had to make a second appointment. At that appointment she finally agreed to write the letter. In other words, to me she said that she agreed to write the letter of medical necessity. BUT it would have to wait until her office person was back before it would be done. I wait about a week and half, and finally it is done and it is faxed over to the surgeons office. The surgeons office calls me "it isn't what we need. i called and they refuse to put that it is medically necessary into the letter".

So what do I do now? I can't afford to go "doctor shopping" to find a doctor that will write the letter for me. I meet all of Aetna's guidelines, and I do have a letter from my PCP they just will not write that it is medically necessary. So do I submit to Aetna anyways or... I don't know.

Any help??

Thanks!

Sorry I didn't respond right away, I just started working and my hours have been all over the place! I would definitely like to keep in touch!! As of yesterday I *still* haven't heard from my insurance so I have no idea if i've been approved or not. My mom (I am under her insurance) told me she would call first thing monday for me. It has been almost two weeks so hopefully i'll hear back either way soon!!

You have been very patient! I hope you have good news tomorrow. Keep us updated!!!! :-)

I was APPROVED! YAY!!! I don't know when my surgery date is yet, but I was APPROVED!!!!!!!! WOO HOO. I called the insurance this morning and they confirmed it for me over the phone!

Yay! on getting your approval!

:Banane03: Congratulations on getting approved! Awesome!!!! :Banane02:

Congratulations!

You guys have the best topic timing!!! I'm feeling so defeated today. I've been through 6 months of PSWL, psyche eval, my PCP sent a letter of medical necessity that sounded more like an obituary, I submitted a letter of my weight struggles that sounded more like a suicide note, and gave all of that data to my surgeon's insurance clerk. She called me today and asked "don't you have a 5 year weight loss history?" I gave her all that I could come up with which was a 5 year gynecologist weight loss history for 2001, 2002, 2003, 2004, 2005 and 2006 (also the PCP from March 2011) to me that shows that I have been consistently overweight since 2001 at least! She was looking for the last 5 consecutive years. she sounded as if I'm going to be denied because of that and said "Well I'll submit it and we'll have to just wait and see" hmpf!

I'm telling you if I don't get approved at this stage, I'm going to be so so so disappointed. What do you guys think? I should mention that I don't have Aetna, I'm in Indiana and have a local network called Physician's Health Plan.

Congratulations!

You guys have the best topic timing!!! I'm feeling so defeated today. I've been through 6 months of PSWL, psyche eval, my PCP sent a letter of medical necessity that sounded more like an obituary, I submitted a letter of my weight struggles that sounded more like a suicide note, and gave all of that data to my surgeon's insurance clerk. She called me today and asked "don't you have a 5 year weight loss history?" I gave her all that I could come up with which was a 5 year gynecologist weight loss history for 2001, 2002, 2003, 2004, 2005 and 2006 (also the PCP from March 2011) to me that shows that I have been consistently overweight since 2001 at least! She was looking for the last 5 consecutive years. she sounded as if I'm going to be denied because of that and said "Well I'll submit it and we'll have to just wait and see" hmpf!

I'm telling you if I don't get approved at this stage, I'm going to be so so so disappointed. What do you guys think? I should mention that I don't have Aetna, I'm in Indiana and have a local network called Physician's Health Plan.

I can't say for sure because I am not familiar with your insurance, but I only had three years to show and I had to dig for those. I think you will be fine! My surgeon's office said the same thing to me "we'll submit and then wait and see". Good luck!

I'm just going to try to be as patient as I can during the waiting period. Meanwhile, I'm really happy that your date came through! Congrats & good luck.