Your Aetna experience?

lonestar5212 · 03-03-2008, 01:16 PM

Tomorrow will be 4 weeks since my paperwork was submitted to Aetna.
The 45 days they have to respond will be over in two weeks so at least I know I will have to hear something by then.

NeNe967 · 03-03-2008, 01:21 PM

I thought they had 30 days to reply.

miss meliss · 03-03-2008, 01:28 PM

Lonestar,
Have you checked to make sure they recieved everything? That seems like a longer time that most anyone one I've read. Hang in there!

dogluvr · 03-03-2008, 02:06 PM

Quote:

Originally Posted by miss meliss

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.

NeNe967 · 03-03-2008, 02:12 PM

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!

lonestar5212 · 03-03-2008, 02:37 PM

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.

lonestar5212 · 03-03-2008, 03:00 PM

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.

lonestar5212 · 03-03-2008, 03:11 PM

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.

lonestar5212 · 03-04-2008, 07:37 AM

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.

NeNe967 · 03-04-2008, 07:46 AM

Quote:

Originally Posted by lonestar5212

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?

lonestar5212 · 03-04-2008, 08:34 AM

Apparently, my company has a medical area made up of nurses and a doctor that works hand in hand with Aetna on approval or denial on pre-cert claims.

NeNe967 · 03-04-2008, 08:40 AM

I pray you get approved. You definitely sound like you are a good candidate.

Good Luck,
Ms. NeNe

lonestar5212 · 03-04-2008, 10:28 AM

Thanks NeNe, I will post as soon as I know one way or the other. My fingers and toes are crossed for you as well. Let us know.

miss meliss · 03-04-2008, 11:10 AM

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

dogluvr · 03-05-2008, 01:04 AM

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

I don't know how young been holding up nen waiting so long. Sigh.