jenjengrins

Send Message

Block

Add Friend

Well, had my one week post-op visit and viola I lost 14lbs since Feb. 27th.  Woohoo!  He said everything looks great and that I'm having my first fill on April 16th.  :-)

So walk out to the mailbox, and the letter said my appeal was approved wooooooooooo.

Well I got a letter yesterday Aetna denied my appeal.  I am so sick and tired of this bs.  I'm not going to give up, but I got to wonder if this is worth it.

Well we will see what happens when all of my paperwork is sent in for the appeal to Aetna.  I'm more pessimistic and the lady at WLSC was so sweet and optimistic..even gave me a hug.  Maybe she knows something I don't, but have to say that I just think that insurance companies are making things so ridged, that they'd want to do a heart or other complicated surgery before something that could prevent.  I don't post all that often so that I don't get my hopes up, but we will see what happens.  I've got to say if it happens it happens..if it doesnt then it doesnt.  I've gotten to the point where I just don't think about it much anymore.  Its amazing the medical records that she accumulated from the doctors its almost two inches thick.  If it doesn't help along with the other requirements, then I dont know what would. 

She seems to think that I'll be approved, but got to be honest I have my doubts.  But you just never know. 

You know how many times have you heard "you need to reduce your stress levels." Only to have the insurance company being the cause of your stress :). 

I'll keep you posted if I end up needing another appointment.

Well today the insurance expert is submitting the paperwork for my appeal.  We'll see what happens :) She said there were enough records to make a small novel.  Ha ha :)  Anyways we will see what happens.

Well like everyone else you get denied for the first time. They said they need documentation of a 6 month physician supervised diet or 3 month physician supervised perioperative diet/exercise programe and documentation of nutritionist evaluation submitted.

Well I was told to check up with the insurace person at the doctor's office and the paper work was submitted on 8/4/2008.  So it is a wait and see process.  I know things will go the way they are supposed to go.  I was reading on here about people with Aetna POS II, but she told me that ever company's plan can be modified to exclude (which mine has no exclusion policy) or requirements can be different.  Keep my fingers crossed.  Oh boy do I need a change in life, seems like lately its been going down the toilet with everything going on.  The only thing I know is thank God its Friday!  She said to call her periodically to see whats going on and she'd call me as soon as she hears anything.

On August 1st, I met with the doctor on my first consultation.  He talked to me, answered questions, and discussed that he does not see any reason why I wouldn't qualify for surgery.  They are submitting the pre-approvals to the insurance which I'm so glad my insurance does not have any exclusions or reasons why one can't have it.  We'll see what happens.