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Your Aetna experience?

I am currently going through the process to have lapband. Starting my 6 month supervised diet this week. Done my sleep apnea, stress test, pulminary function test, and a few more. Waiting for results. I have aetna NAP choice POS II. I want to make sure since i am spending all of this money for these test and supervised diets (around $ 800) that i have every thing that aetna needs to approve me for the surgery. The only thing that i worry about is the proof of being 40+ bmi for 5 years, even though i have. There were a few years in between that i didn't go to the doctor (not even the female doctor ) so i not for sure if i can come up with these records. So i would just like to here anyones experience with aetna good or bad. I really want this surgery so information would be very appreciated and helpful.

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NeNe & Dogluvr I'm watching y'all with my fingers crossed!! Hope you hear soon! I submit on April 7th.

Thank you soooo much. It just comes down to whatever review nurse got our files you know? NeNe have you called them? If my wait goes past the 2 week mark I think I will be calling. Your approval should be just around the corner, heck it could even be today! Have faith. Its only been 3 business days since they got my files and already Im depressed Im not approved yet lol.

dogluvr,

I have not heard anything yet. I don't even know what number to call. The last time, I received a letter in the mail. A day later, my doctor's office called me do discuss. I will just patiently and positively wait.

Good luck to everyone!

Miss Melissa -

Yeah, they told me they have everything. Actually, my center sent them everything on 1-28, then Aetna wrote me and said they didn't have everything so my center sent it again on 2-4. I called Aetna on 2-5 and they said yes they received everything and sent it to medical review that day (2-5). I called alot at first and they just kept saying I was in medical review, so I stopped calling. I may call after I finish typing this just to see if I can get past the front line!

NeNe - they have 45 days.

Okay, I called Aetna. This is what I was told. "It was referred to the Medical Director for review and after he makes his decision they will notify my doctor." FYI-I have sleep apnea and diabetes along with high cholesterol. Did a year with my PCP and did the 3 month thing with my surgery center. Had psyc eval. and nutritionist counseling. Supplied required health history. Don't know what else to do at this point. I basically don't hold out hope anymore that I can get approved. I think they are just looking for a reason, any little reason they can find to deny me. This is just a beatdown.

One more thing, when I call, I get the impression pretty quickly that they really don't want to talk to me. They always tell me that my doctor will be notified, like I shouldn't be calling them. I hate that. I just say that I want to make sure that they aren't still missing any documentation, and today I added the part about it being 30 days tomorrow. No reaction to that at all.

Hate to be a stalker here, but have so new info. It appears that my company has a say in whether I get approved also. That sounds like I am doomed here.

Lonestar,

If it is a covered procedure with your insurance...I think it's unfair that they get to have a say so regarding if you get the surgery or not. Did they say who at the company gets to decide if you get the surgery or not?

Lonestar...

I can tell by your name and doctor that we are from the same neck of the woods, DFW. I'm in Burleson. Do you mind telling me the employer your working with. I just need to know if I will be having the same painful, needlessly long wait. I will be sending in my paperwork 1st week of April. I have Aetna thru Lockheed.

Don't feel like a web stalker. I am very interested and how things go for you and the other Aetna people on this site. ... Miss Meliss

So my friend is being banded tomorrow 11 am, the one that got approval in one day, and I'm so depressed all I can do is cry. We went through the process together but she would make her apts before mine so she finished and submitted a week before me. Without an approval yet I feel like I'm being left behind. I don't even want to go to work or leave my couch until I get that call:unsure: I don't know how young been holding up nen waiting so long. Sigh.

So my friend is being banded tomorrow 11 am, the one that got approval in one day, and I'm so depressed all I can do is cry. We went through the process together but she would make her apts before mine so she finished and submitted a week before me. Without an approval yet I feel like I'm being left behind. I don't even want to go to work or leave my couch until I get that call:unsure: I don't know how young been holding up nen waiting so long. Sigh.

dogluvr,

Don't beat yourself up. You will be approved before you know it. Get up off the couch and do what you have to do to get prepared for your new life. You will be approved!!!!

Praying for you,

Ms. NeNe

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