Question:
What should I make of this?

I just got off of the phone with my insurance company. The lady (which has been the most friendly and helpful person at Aetna) that I have talked to, told me that it says that my claim is still pending, but she asked me to hold on so she could find out what is going on. After a few minutes, she came back on the line and told me that it looks like it was supposed to be approved, but it seems that they forgot to basically click the Approval button. She wrote the correct people a note saying that it was urgent that I know what is going on. I am scheduled to have surgery in 3 days if I am approved. Hopefully I will receive a phone call tomorrow giving me an answer. Has this happened to anyone else, and what was the outcome? I would like to do my happy dance, but don't want to do it to early.    — shellkov (posted on November 8, 2004)

November 8, 2004
I wish you a speedy approval. My insurance company decided to deny me 2 days before my scheduled date. I am now in the appeals process. Good thougths going up for you.
   — Suzanne T.

November 8, 2004
Something similar happened to me with Humana. I was told I was approved, it was listed in the system and everything. but then I got a call from my surgeon's office saying that they were still waiting for approval from Humana. When I called them I was told that the system notes showed it was approved but some kind of flag was never turned on to change the status from pending to approved. I told the rep this needed to be done ASAP because my surgery was in about 1 week. He said he'd get it taken care of, I got his full name and ext. and called the next day to make sure everything was ok, and it was. Best of luck email me if you need anything else.
   — vllgmz4

November 9, 2004
I haven't had this problem before, however I have worked for doctors in the past and have had to deal with the insurance companies. My best advice to you is you call them every day twice a day if you have to and make sure that the situation is worked out. Don't wait for them to call you, because even though you got someone that sounded like she new what she was doing she could drop the ball as well and I wouldn't want you not to be able to have your surgery. ALWAYS GET NAMES EXT. AND DEPT AND TIME YOU SPOKE TO THAT PERSON. GOOD LUCK BUT IF YOU WANT THIS DONE SOMETIMES IT PAYS OFF TO DO THE WORK FOR THEM. STAY ON THEIR BACKS
   — Sabrina L.

November 10, 2004
Well, just like a suspected. Aetna is starting their bullcrap just as I have read that many other people have had. My surgeons office called them and they say they don't have anything on me. That is very interesting especially since I have been calling many times a week for the past month or so. They sure were finding me on the computer all of those times. This has been so depressing since I thought everything was moving in the right direction. I will keep you all informed. Keep your fingers crossed for me! Thanks!
   — shellkov

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