Aetna Sleevers - Share Your Approval And/or Denial Experiences Here!

[buplee 556]

Aetna did the same thing to me after my first denial. I was told I did not complete my 90 days when in fact I completed 120 days over 4 consecutive months.

[becky2013 11]

Someone had there dates wrong!!! Call them yourself they will answer any questions you have.

Thanks ChrisBthin, I did call them and they stated that my Doctor will have to appeal which he is going to do as soon as they receive the denial letter.

[becky2013 11]

Aetna did the same thing to me after my first denial. I was told I did not complete my 90 days when in fact I completed 120 days over 4 consecutive months.

Hey buplee how long did it take for your approval to come in?

[buplee 556]

Hey buplee how long did it take for your approval to come in?

I hope you do not have the same experience as I. I ultimately fought with Aetna for 18 months. I was denied twice and then hired a healthcare advocate who wrote a letter to the chief medical officer threatening to go the media and to sue. After, that Aetna reversed their denial.

BTW- Aetna contradicted their own policy. My bmi was 49 but I had no comorbities which is why I was denied twice. Good luck to you on getting approved and your journey.

[becky2013 11]

Man that stinks. So sorry you had so much trouble. Sure hope the letter the Doc sends will be enough. So glad you got your approval and good luck with your new life. Praying all goes well with you.

[buplee 556]

Man that stinks. So sorry you had so much trouble. Sure hope the letter the Doc sends will be enough. So glad you got your approval and good luck with your new life. Praying all goes well with you.

I am 5 months post-op and 84lbs down so far and shrinking. I hope you get your approval soon.

[becky2013 11]

Doc. submitted paper work on Friday 7/12/2013. Still waiting to hear something from Aetna. If approved I think my surgery date will be 8/12/2013. Will be so happy to get this done and hope to get off my BP meds' date=' CPAP machine, Fluid pills,and hope my Knees feel better. I pray that the Lord guides the Doctors hands while he preforms this surgery on everyone having the surgery. NO LEAKS!! AMEN[/quote']

[becky2013 11]

.

[lynn2win 142]

Anyone currently going through approval for Aetna....I was told that I have0 day so just wondering how long it taking some people just had my first visit lil over week ago...

[afern 0]

I started my journey in November 2014 (first dr appt) and completed the program (3 nutrition appts, 3 physical therapy apps, 3 phys appts) and meet with the Dr on February 7, 2014. The Dr's office submitted my paper work to Aetna the last week of February and on March 7th I received a denial letter. I called the insurance company to obtain the details behind the denial. They told me that I gained weight in the 90 day program. I actually did not gain weight during my 90 day I lost about 2 pounds. Come to find out the insurance company was using a weight from October 2013. I called the Dr's office to try and find out more details and they are not sure about the October weight or where it came from. I am so frustrated as I have followed the program and have a bmi of 40, sleep apnea, and pcos. The Dr's office has appealed and submitted the paper work on March 11th. Has anyone received an approval after a denial letter due to an incorrect weight? How long does the Aetna appeal process take?

[lynn2win 142]

bump

[LivingForGod 111]

I started my journey June 2013. I had to do 6 months of weight management classes. sleep study, upper GI check and pulmonary clearance. My paper work was submitted 12/13/13. On 12/19/13 got a call I was denied. I was denied because I gained weight. So I appealed it. I have arthritis and degenerative disc disorder in my lower back. So I couldn't exercise what so ever. I could barely walk and stand. So I had been going to the dr over 2 years about my back. I also have PCOS. So I got all my records from my dr about my back. And I got all my records from my obgyn about my PCOS. I wrote a letter as well. I sent all this to aetna on 12/30/13. Because of the holiday aetna didnt get my papers until 1/3/14. On 1/7/14 my denial was approved. I had surgery on 1/31/14.

[Jennifer2575 55]

Approved today!! Surgery is April 8th!! Aetna approval process went very smoothly!!

[upurg 27]

Please help. Any advise would be appreciated.

From my understanding Aetna requires 6 months supervised weight management with 3 consecutive months. Or

3 months with NUT, dietitian and classes.

I have been seeing my primary for years and we always try to manage my weight for the 3 months I have seen him monthly.

The advocate at my surgeons office seems is telling me I may not be approved ????

I am scared I will have to start over. Please share your experiences with Aetna. Should I try with my primary's. Notes first. Or just pay the $300 to take my surgeons 3 month program

[ssimmons1124 12]

@upurg..whats your bmi?