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Waiting Game sucks... Anyone recently submit to Insurance?

mrobles1027

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mrobles1027    7

mrobles1027
Posted

I am getting a revision from lap band to sleeve. I got my lap band in 2010. Everything worked fine until I had minor complications almost a year later and after I had my daughter. So it really isnt working for me anymore. I have almost gained all my weight back. I look forward to my journey with my sleeve.

However, my doctor's office submitted my paperwork to Aetna on Oct 24 and still havent heard anything. Ive checked with the coordinator and Aetna and they just tell me its pending. Today is the 10th business day from when it was submitted. Aetna said additional information was submitted on 11/2 and told me to check on Monday.

Anyone else playing the waiting game? Im ready to get this party started lol ;)

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HuneComz    103

HuneComz
Posted

I also have Aetna and I had my last appointment on 10/21 and was told it would go to insurance and take approx. 10 days. Today is two weeks/10 business days so I called my surgeon's office to check on status and they are only submitting today. So disappointed...I thought I was at the end of the waiting period and it is just beginning.

Hopefully we both hear good news. Please let me know how it goes for you since we have the same insurer.

I am having the sleeve and my only qualifier is my BMI of 44.

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mrobles1027    7

mrobles1027
Posted

Oh bummer. Well at least it's still in process. I'm sorry to hear that. You should call Aetna directly on Monday just to make sure they have everything. I've called them twice this week.

Yes I hope Aetna delivers good news next week. Please let me know as well when they tell you.

My only qualifier is my BMI and having complications with my band. So we'll see.

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CariC    12

CariC
Posted

I was submitted to AETNA on the 14th called a few dys later and thry told me they received the request but no clinical ingormation. Called my doc and tbey resubmitted the clinicals on the 24th and received approval the 31st. My surgery is on the 23rd of November. I suggest calling member services and requesting status and any notes made so far in case you have an issue like mine.

Sent from my SM-G935T using the BariatricPal App

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mrobles1027    7

mrobles1027
Posted

I was submitted to AETNA on the 14th called a few dys later and thry told me they received the request but no clinical ingormation. Called my doc and tbey resubmitted the clinicals on the 24th and received approval the 31st. My surgery is on the 23rd of November. I suggest calling member services and requesting status and any notes made so far in case you have an issue like mine.

Sent from my SM-G935T using the BariatricPal App

I called earlier in the week and the rep I spoke to last called me back a bit ago and told me that is still pending. He'll call me on Monday he said.

Sent from my iPhone using the BariatricPal App

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gemveg    0

gemveg
Posted (edited)

I'm playing waiting game as well. My appt was 11/27 but don't expect to hear for a couple of weeks. I'm on Neighborhood Health Plan in the Boston area. Don't know how they are. I'm also started to get concerned about the continuity of my insurance since I'm not insured through an employer but through Obamacare (not to get into politics). Anyone else worried about this issue? I am hoping for a surgery in late December.

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Edited by gemveg

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jaynamy3    122

jaynamy3
Posted

My paperwork was just sent in today. Hoping to hear something in the next 10 days or so. When I joked with my coordinator about the horrible stories I have heard about Aetna liking to deny a lot the first time around she kind of laughed and said that's not the company she gets denials from. Personally she said she has never had a denial from Aetna. Lol. Weird how you hear different comments.

❤️️Amy ❤️️

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mrobles1027    7

mrobles1027
Posted

I'm playing waiting game as well. My appt was 11/27 but don't expect to hear for a couple of weeks. I'm on Neighborhood Health Plan in the Boston area. Don't know how they are. I'm also started to get concerned about the continuity of my insurance since I'm not insured through an employer but through Obamacare (not to get into politics). Anyone else worried about this issue? I am hoping for a surgery in late December.

Sent from my iPhone using the BariatricPal App

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mrobles1027    7

mrobles1027
Posted

I'm playing waiting game as well. My appt was 11/27 but don't expect to hear for a couple of weeks. I'm on Neighborhood Health Plan in the Boston area. Don't know how they are. I'm also started to get concerned about the continuity of my insurance since I'm not insured through an employer but through Obamacare (not to get into politics). Anyone else worried about this issue? I am hoping for a surgery in late December.

Have you tried calling them? I hope you get your approval soon. I also want to get it done before the end of the year because my deductible has been paid and it will increase next year. Best of luck. Keep us posted!

Sent from my iPhone using the BariatricPal App

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mrobles1027    7

mrobles1027
Posted

My paperwork was just sent in today. Hoping to hear something in the next 10 days or so. When I joked with my coordinator about the horrible stories I have heard about Aetna liking to deny a lot the first time around she kind of laughed and said that's not the company she gets denials from. Personally she said she has never had a denial from Aetna. Lol. Weird how you hear different comments.

❤️️Amy ❤️️

That's good to know. My doctors office said that they got a denial for someone who didn't lose weight in the 6 Month diet. Keep me posted!

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mrobles1027    7

mrobles1027
Posted

Is there's anybody from Alabama? Can you tell me how long does b/c insurance take to approve you if you work for the State of Alabama. I'm really wanting to be sleeved.

Sent from my iPhone using the BariatricPal App

I'm in CA. So I wouldn't know. Have you started the process?

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Sai    785

Sai
Posted

I remember the waiting game for my band to sleeve revision. My bariatric center sent the paperwork in April, I was denied quickly because I had no medical issues, was lower bmi (due to band)... Etc. At that point, I was content to let my band rest since my band had been good to me (they unfilled my band for being too tight), and come back 3 months later to get it filled again. A month later or so, I get a call they approved me on second appeal... Then it got very real lol.

Sent from my SM-N910V using the BariatricPal App

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