Appealing Aetna
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I was denied by Aetna and we very frustrated because the insurance said My sleep apnea was not severe enough to warrant surgery. With a BMI well over 40 for over two years, my surgeon believed it would be a simple peer to peer to explain the apnea was irrelevant. I was again denied. When I received my letter it stated my BMI had not been over 40 for two years. This baffled me, the insurance gave me dates of service when my bmi was 35-37 then 43, the following month. This didn't make sense to me as I know I have not lost any weight over the last few years. So I asked my doctors(gp) office to research. It turns out that there is another patient in the office with the same name and she is 5 inches taller. On two occasions they entered my height incorrectly! I am hoping with the new information, my appeal will go though. I am posting because I was ready to give up. I may still be denied, but not without a fight. Thank you everyone who told me to fight, question, and keep calling (insurance and docs office)till I get someone who will help.