Waiting on approval from Aetna

[Mommabird 367]

I had a gastric bypass, not the sleeve, but I do have Aetna. I had to lose weight for six months and then not gain before my final appointment before all the paperwork work was sent to Aetna. The papers arrived at 4:30 PM (I know cuz I was on the phone with the Aetna rep when they came over the fax machine) She put the packet together and sent it to the ones who approved or deny surgery. I got a call at 8:00 AM the next day with my approval. I got them to fax me a copy of the approval letter which I then faxed to the surgeon's office. This was on a Friday. I got my surgery date the following Tuesday and had surgery two weeks later.

[nurseforlapband 11]

My paperwork was submitted last Thursday and I'm still waiting for an answer. I called Aetna today and they were waiting on physician notes from last week to complete review for approval, it was faxed over today, so I should have an approval tomorrow. I have called them everyday, sometimes 2x a day, so you are not bugging them....it's their job!

Edited July 16, 2015 by nurseforlapband

[Joymarie333 41]

I am also waiting for approval from Aetna. Everything was submitted this week. I hope I get good news soon! Good luck to you!

have you received any word

[Ms. Nunya 126]

I have them. With my lower BMI, I just did not feel like fooling with them, so I'm going self pay. Good luck to you.

[LaLaLucy 22]

Joymarie I am still waiting on approval. I called Aetna on Friday afternoon and it was still pending. My surgery date is August 11th if all goes through.

[Joymarie333 41]

I called Aetna and they said mine was pending too they told me that the date they put on my paperwork was for August 4 but I don't know if that's an actual date that I can have surgery on because I know I have to do a 2 week liquid diet? Also when I called the insurance company they told me that West medical submitted my application to them on a Friday but they had to cancel that application because they put outpatient procedure and they said they resubmitted it on the 14th to inpatient procedure so I guess they just made a mistake. It's been a total of 5 days! How many days have you been waiting?

[LaLaLucy 22]

I think mine was submitted last Tuesday and Aetna asked for additional information and the office submitted that Wednesday. They confirmed they had everything they needed when I called Wednesday. Maybe we will hear good news on Monday! Keep me posted!

[xrayyoung22 16]

I have Aetna and didn't lose any weight during the 3 month diet (I couldn't or my bmi would be too low). I also haven't had this BMI for more than two years. I was originally denied but once the doctor submitted better documentation of my 90 day supervised diet, I was approved within a week. Surgery tomorrow.

[nurseforlapband 11]

I'm also hoping to get an answer from Aetna tomorrow after going back and forth with them last week. Good luck to you @@Joymarie333 and @@LaLaLucy! Wishing you the best with your upcoming surgery @@xrayyoung22!

Edited July 20, 2015 by nurseforlapband

[arenea 61]

I have them. With my lower BMI, I just did not feel like fooling with them, so I'm going self pay. Good luck to you.

Hi I'm new to the thread and couldn't help, but to notice your username:)

[jenjen2781 30]

I have Aetna only lost 11lbs in my three month process. They approved me in 1 week. I used the nicholson clinic in dallas tx. They made sure I did everything right and had all my paper work. Surgery is Monday 7-27-15 my 34 birthday.

[Joymarie333 41]

I'm also hoping to get an answer from Aetna tomorrow after going back and forth with them last week. Good luck to you @@Joymarie333 and @@LaLaLucy! Wishing you the best with your upcoming surgery @@xrayyoung22!

. What did you have to go back and forth about with Aetna, what did they try to say

[Joymarie333 41]

I have Aetna only lost 11lbs in my three month process. They approved me in 1 week. I used the nicholson clinic in dallas tx. They made sure I did everything right and had all my paper work. Surgery is Monday 7-27-15 my 34 birthday.

congratulations I send blessings your way, keep me posted on the process

[jenjen2781 30]

Thank you so much joymarie333. Let me know what happens with atena. I was worried too. But As long as you did all your requirements they will approve.

Edited July 20, 2015 by jenjen2781

[nurseforlapband 11]

I'm also hoping to get an answer from Aetna tomorrow after going back and forth with them last week. Good luck to you @@Joymarie333 and @@LaLaLucy! Wishing you the best with your upcoming surgery @@xrayyoung22!

. What did you have to go back and forth about with Aetna, what did they try to say

Just making sure they had everything they needed. The MD office forgot to fax all of my information, so had to gobetween aetna and MD office to make sure everybody had what they needed. I'm an inpatient person anyway (working on that), so it just makes it a little harder for me.