Originally Posted by jmh324

After 30 years of battling my weight I finally made the difficult decision to consult with a bariatric surgeon in March. My BMI is 40-41 and I just recently was diagnosed with sleep apnea. My insurance is Aetna and I went through the 3 month multidisciplinary program and did everything I was supposed to. My surgery was scheduled for today. Two weeks ago my doctor's office supposedly submitted everything but it took until last Wednesday for Aetna to confirm there was even a case pending. Friday morning they denied me based on the fact that although my BMI was 40 in 2007, it did drop down to 36 for a couple of months in 2008 when I was on a SEVERELY restricted anti-candida diet. They are saying I didn't have sleep apnea then so that disqualifies me. My doctor's point is that I just had not been diagnosed. In my doctor's notes from 2007 it very clearly states that I was having sleeping problems, but no one thought to test me for apnea. Anyway, since Friday morning they've been trying to set up a peer-to-peer phone call with Aetna. I'm not sure what the hold up is but every time I call they say they are waiting for the insurance guy to call back. My doctor's office said if they get the approval via the peer-to-peer (they intend to fight for me tooth and nail) they can reschedule me for Wednesday, but today was another wasted day. I'm not going to work tomorrow because I'm so stressed and do not feel like dealing with the "have you heard yet" questions. I am so upset and so disapppointed right now I just don't want to see or talk to anyone.