How long do appeals take?

dianne220
on 12/1/11 11:26 pm - TX
VSG on 10/02/12
I sent my appeal in 8 1/2 weeks ago.  I called my doctor's office again and she said they can take "forever".  In the beginning she said it would be only 6 weeks but now she said she doesn't want to call and bug them becuase it might upset them and then they could deny it.  Initially I was supposed to have surgery in June but it was denied.  I got a co-morbidity in September and now I am just waiting.  Has anyone had an appeal with Aetna before?  How long did it take?
Thanks!
johnsoca
on 12/2/11 1:52 am - Madison, AL

You can call and check on the status of your appeal yourself. Call the customer service number on the back of your insurance card.  Get the name of the person you speak with and ask for a reference number for your call (and write it down.) Continue to call at least weekly until you get a decision. Knowing that you are staying on top of the process may help it go a little quicker.

Good luck!

 

                
knowbetterdobetter
on 12/2/11 2:15 am - FL
RNY on 03/26/12
Call Aetna. I deal with them everyday (I work for a hospital). Def get that reference number. Ask the rep about the appeal. They are usually very helpful. You will not be bugging them at all. I know from submitting hospital appeals that it can take quite some time but they should be able to give you some info. There is also another number in addition to the reference number you can ask for but I am not at work and can't remember what its called. I dont know if its as case or document number. But call!!
dianne220
on 12/2/11 4:13 am - TX
VSG on 10/02/12
Thank you both for your advice.  I did as you said to and it turns out that my appeal was never sent in!  I faxed it to my doctor on 10-5.  On 10-28 I called my dr. office to check on it and she said I was being impatient.  I then waited until 11-18 and called the dr. office again.  She then said she would put a note in the file to call the insurance for me.  I called back today on 12-1 and she said it could take forever and that if she kept calling then it would **** the insurance off.  Well it turns out they didn't call on 11-18 like she said they would and now it has been 9 weeks and 2 days since I faxed the new diagnosis to them.  I am furious and crying again.  We buried my niece 2 days ago and this is the first day since she died that I've done anything productive.  Now I am defeated once again.  I am so mad.  I wish I would have called sooner but they said they would do that.  

Now I am going to a different doctor tomorrow for their information seminar.  How can they do this to me?  Also, when I was denied originally in July, they never called to tell me.  I got a letter from the insurance.  The doctor's office had to have known first.  I have never heard anything bad about this doctor's office so I am amazed at how I'm being treated.  And now they are too busy to talk to me...... go figure.
knowbetterdobetter
on 12/2/11 6:18 am - FL
RNY on 03/26/12
Wow. I am so sorry you have to go through this with your surgeons office especially after your niece passing away. My heart goes out to you and your family. Find another surgeon quick. I wish you the best.
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