Insurance, Cash Pay and Financing

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autigers10
on 8/9/12 5:52 pm

PS I forgot, but since 2011, ive been morbitly(sp) obese, according to BMi calculations. It's now over 40+. Which has been that for over a year and 1/2. thanks again

autigers10
on 8/9/12 5:48 pm

Topic: RE: Aetna Appeal Letter

Hey Ms Nan. Dont know if you are on this site anymore. I sure do hope so. Im doing some research cause I received that call from my surgeons office that Aetna denied me for VGS. SO, I goodled appeal letters and came across this website and this forum. I saw where you helped someone w/ their letter to Aetna in an attempt to have my denied surgery, approved. I havent yet received my "offical" letter from Aetna yet, but when the surgeons ofice called me w/ the bad news, she told me it was due to my weight history. One time in 2010 my bmi was like 35.? and another time in 2010 it was 37.? And then they brought 2009 in the picture. Im like WTH. SO, I see that you have some experience on writing quite a few appeal letters, may I have your expertise on mine? I would sooo much appreciate it.
Hope all is well w/ you.
Thank you soo much!
Paige

autigers10
on 8/9/12 5:39 pm

Topic: RE: Aetna Appeal Letter

Hey there. I see that your surgeon is Dr nicholson as well. And I just got a call today from his office that Aetna denied my surgery. Any luck w/ how to go about writing this letter. And do you know if Dr nicholason will write an appeals too? thanks for your response.
have all is going well.
Paige

Back2me2011
on 8/8/12 9:28 am - Miramar, FL

Topic: RE: Avmed State of Florida

Hi Nikimona,

I'm a new member here, and I too also have Avmed through AT&T. Baratric surgery is not covered through my husbands benefits.

i'm a bit upset because I really need this surgery. I have no health issues, however my body has been taking a beating from all this extra weight. I'm currently 262.2 my heaviest weight. Before I had my son 2 yrs ago I was 232-238lbs. Since I've had him my weight has been climbing my knees hurt. I have heart palpations, and I even look different. I went to my PCP today and she advised me to do all the things I have done and been doing. Excercising, I've done Alli, Weight Watchers, Gym memberships, Phertmine, etc. and nothing has happened/ I would like to know if they approved you and what was the process like. Maybe you can guide me and give me some hope!!! Your response is greatly appreciated. Thanks

Jennifer39
on 8/7/12 6:31 am

Topic: RE: Self Pay

Im wondering the same thing and hope to hear from other people on your post.
Let me know how it goes for you!

Auburnmist
on 8/3/12 11:28 am - TX

Topic: Just a question (???huge bill???)......

Hello Everyone. I have read several post throughout the boards that a person has received a huge bill from the hospital after surgery even with insurance approval. How is this possible if you have approval from insurance company and a max out of pocket? I'm starting to wonder if I need to call my insurance company myself and confirm my responsibility. Is something not being mentioned when peeps are saying they got a huge bill???

Thanks!
Auburn

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Member Services
on 8/2/12 11:54 pm - Irvine, CA

Topic: OH MAGAZINE - PLEASE LET US KNOW!!

We've created a survey about OH Magazine and we'd like to hear from you! The survey will only take a couple of minutes of your time but will let us know what you want regarding our OH Magazine.

Please click HERE to join the survey.

Thanks!!

Sincerely,
ObesityHelp Management and Staff

alycat75
on 8/2/12 11:58 am - Indian Trail, NC

RNY on 01/14/13

Topic: RE: Cigna Changed Diet Policy

I agree! I've got Cigna and that was my last hurdle to apply for approval! All engines are go now

enicholsRT
on 8/2/12 2:35 am

Topic: RE: Aetna Appeal Letter

Can you help me with the appeal process with Aetna. I had lap band done in 2004. I have never been able to get fills in my band. I get very ill anytime they try. So I found a new bariatric surgeon and he tried t get Aetna to approve a revision, so he will take out my band and then do a sleeve. Aetna will not approve the Sleeve, but they will approve the band removal. My doctor told me I could do an appeal. There reason is because I have no documented co-morbidities. I have a BMI of 39 but no other health issues. I have done several diets, had a band and cannot lose weight. If possible would you please help me with the appeal process.