details... - ThinnerTimes

Toony · 12-13-2007, 01:27 PM

Learning as I go...

I started this whole journey thinking LAP BAND, but quickly realized that is NOT for me... somehow that transition did not get relayed to the insurance company... so BE SURE --- even if you have to repeat yourself every single time --- to make sure your paperwork is submitted correctly!!!

I called today to verify my APPROVAL and the Aetna rep said, "This is an outpatient procedure, correct?" Argh!!! Now I'm waiting for the case manager to call me back to get this miscommunication straightened out... sure hope this doesn't burst my bubble!!!

The bubble I've been floating on since Monday night!

...to be continued...

CeeCee · 12-13-2007, 01:33 PM

Good Lord! Fingers crossed...

janine · 12-13-2007, 02:49 PM

oh, my!... I have Atnea insurance and this may meen that they have to resubmit the whole procedure again because the ry is not approved... Wow!... After all the time you've spent and how your excitement has been. In time it will happen. Hold on to your seat!

Toony · 12-13-2007, 02:53 PM

Well, I think it's just a matter of the WLS team calling Aetna with a different procedure code... hoping it won't change things.

I'll find out soon, I guess... meanwhile, I'm going with the assumption that all things are GO for Feb!!!

Katie

Jeri · 12-13-2007, 03:12 PM

Good Lord.

Just said a quick prayer for you.

janine · 12-13-2007, 03:48 PM

Yes, that's what I thought but here's my story.
I was approved for surgery the ry open in june when my surgeon and I had a discussion on his procedures and how I wanted information on donating my own blood for the surgery. He was so upset over my question that he cancelled my surgery wich was scheduled to happen the next week. I then realized that he had some issues that I had not known about prior to that appointment. I thought oh well.. I'm already approved I'll just get another surgeion that doesn't have a problem answering my questions. I found out that all the other doctor's in Tucson were not on my insurance approval list so I ended up going to phoenix and finding another doctor. Now, when I contacted Aetna rep.'s they said the process would have to start over... The new doc had to resubmit all the information and be approved seperately. They were not willing to change codes ect... they claimed it was there way of processing. Ok.. so I was approved by october.. and had the surgery oct. 23. So, you see... I don't know what their procedures are in totality but for me it was a re-do.

coptergirl · 12-13-2007, 05:33 PM

Oye Katie - I am keeping my fingers crossed for you my friend...

And Janine - my doc required autologeous blood donation of 2 pints prior to my open rny - it is your option if it is not required!!

Squishy · 12-13-2007, 05:43 PM

Oh my.....

You really did not deserve this little setback, but I think it is just that... a little setback. I'm going to bet that you will still be on the schedule in February.

Please keep your chin up and keep us posted!!!

Your pal,
-Mike-

Toony · 12-13-2007, 06:08 PM

Got the paper approval from Aetna today --- Yup! Approved for Lap Band! LOL!

Putting that aside for now - I'm dealing with pain at level "9" in my knee right now... Hoping this is the "rebound" pain my dr. mentioned... "It'll get worse before it gets better..." I'm downing Hydrocodone and Ibuprophen.... trying not to cry!!!!

My assistant said, "Stay home tomorrow unless you feel like you get more rest here at the office." No Kidding!!!

Katie

rappaport · 12-13-2007, 06:35 PM

Quote:

Originally Posted by janine

Yes, that's what I thought but here's my story.
I was approved for surgery the ry open in june when my surgeon and I had a discussion on his procedures and how I wanted information on donating my own blood for the surgery. He was so upset over my question that he cancelled my surgery wich was scheduled to happen the next week. I then realized that he had some issues that I had not known about prior to that appointment. I thought oh well.. I'm already approved I'll just get another surgeion that doesn't have a problem answering my questions. I found out that all the other doctor's in Tucson were not on my insurance approval list so I ended up going to phoenix and finding another doctor. Now, when I contacted Aetna rep.'s they said the process would have to start over... The new doc had to resubmit all the information and be approved seperately. They were not willing to change codes ect... they claimed it was there way of processing. Ok.. so I was approved by october.. and had the surgery oct. 23. So, you see... I don't know what their procedures are in totality but for me it was a re-do.

Which worked out in the end for you, because you ended up with arguably the top-rated surgeon in Phoenix.