Jeanie

I was denied twice & appealed twice and won the 2nd time around. I was with Cigna at the time. The 2nd time I sent the appeal my PCP helped me write the letter and we sent copied of my medical file. SO IF you have to go thru this again that might be something you want to do. Send in all your medical history (even thought they should have it already). Good luck!

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Lap Dr. Callery
July 7, 2004
Savanna Annmarie was born on 10/14/2008

adagirl

Oh why oh why do I always get my hopes up??? I guess I'm just an optimist! OK, so I think I've done a pretty good job keeping my emotions in check since I sent in my second appeal. Realistically, it is VERY unlikely that they are gonna change their minds and its not that big of a deal to wait until January to resubmit. But, I find myself anxious again waiting to hear back. I sent a message to member services last night since they seem pretty consistent that they seem to always make their decisions in about a week (at least my first denial and second denial were each made in a week). So, I expect to hear back from member services today... approved, denied, or still working on it. Oh, I hope hope hope maybe by some fluke they will approve me. In the meantime, I am going to Jazzercise and grocery shopping. I will NOT sit here at the computer and keep pressing the 'check mail' button. That is so NOT healthy for me. LOL

dswofford

That's funny. i have found myself clicking on the check mail button myself. I keep calling Aetna too. I think I call them 3-4 times a day. I hope today is the day..

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Deborah Swofford
5'2"
Starting/Current/Dr Goal/My Goal
274/265/170/140
Staying in the moment the best I can!

adagirl

Update... Aetna says now that they haven't received my second level appeal yet. But, I have a message from them from 10/28 saying they had received it and forwarded it on to the appropriate department for handling. Sooooo, I messaged them again. I'm pretty sure the first response was a canned response (they probably never even checked to see if they got it yet - just said that to make me go away), but I'm calling them on it. There's no way they did not get my appeal yet. Its been 9 days and mail only takes 2 days, 3 days max. Anyway, I also attached it to my message so they will at least have it electronically if they can't find it physically.

Oh well, more waiting... I have to keep reminding myself that the answer is probably still gonna be no so I really should not get too worked up over it.

Meg_pie

Does anyone know how long it will take BCBS of Tennessee
to approve my surgery? They got the paper work tuesday, my
case manager called an didn't have any questions for me.
I'm sooo nervious!

FatButNotHappy

So what is the word??? Any news today?

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Stacie
OH...I was FINALLY APPROVED, baby. Surgery scheduled for 12/7/09

10/02/09 APPROVED
08/06/09 DENIED

5' 3.75" (always said 5'4" until BMI came into play)
242/240/150

Blah Blah Blah Who cares about all that other weigh-in crap that I had listed in my signature before, I was friggin approved!!!

YEEE HAW!!!!

adagirl

They still claim they never got the one I mailed even though they said previously that they had. But, I attached the entire text of the second appeal to my last message to them so they did forward that on to the appeals department for processing. Soooo, I'm guessing it will probably take at least another week. I'll probably send another message on Thursday I think.

adagirl

OK, I couldn't wait until Thursday to email them again so I did last night. And, I just heard back now...

I AM APPROVED!!!

ashleyw889

Woohoo! That's awesome! I'm so happy for you!!

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First Appointment with Nut.: Feb. 24, 2009
Pre-Op: Nov. 11, 2009
Lap Band Sugery: Nov. 13th, 2009