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They agreed!

Alexandra

By Alexandra, in Insurance & Financing

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Alexandra    55

Alexandra
Posted

It's happened! I just got a call from a lovely woman in the Aetna External Review department to tell me that they and my surgeon have come to an agreement!!!

Oh my god. I feel like screaming! I can't believe it. I think I'm hyperventilating...:):D :D

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lmtorb    3

lmtorb
Posted

We're all cheering for you!!! You're such a help on this website that you deserve to have the surgery covered and THEN some!! Please keep us posted!!

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Alexandra    55

Alexandra
Posted

Thanks, y'all! :D

I've calmed down a little bit, but I swear, I was almost in tears when I got the news. Now in retrospect I wonder if the deal was ever really in danger at all. After all, Aetna had to comply with the directive of the independent review or risk being harshly penalized. Did my doctor's office really have to fill me in on the difficulty they were having negotiating? Did my intervention help at all, or did I just piss people off who were trying to do their jobs? Was I a pawn? There are such games that go on when money is concerned, I guess I'll never really know the answer.

The recent trials were just the denouement, though. In the past year there were three appeals before the decision to overturn was made. I really wonder if I would have been able to stick it out through this whole depressing long process if I weren't an insurance broker myself. It helped me to stay inspired to look at the whole thing as a learning experience--knowing that I may someday be able to help someone else, perhaps a client. With that detachment it was possible to keep the search for information academic, even though at times I was inclined to passionate mood shifts (to say the least :) ).

But it's all over now, and now I'm on to the next step. I can't believe a year has gone by since I started reading about the band and posting my frustrated questions--a year later I'm still sitting at the same computer, in the same chair, wearing the same size-28 shorts, but now the future looks entirely different.

Next year, they will be size 18 shorts!!! :D :D :D

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Go To Topic Listing Insurance & Financing

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