Still PENDING. 11 days to go. HELP

Well I am totally freaking out. My surgery is scheduled for 9/6, and Aetna is still pending. First some representative from Aetna told me "yor policy does not cover the proceedure" after they gave me a referral to the bariatric surgeon, another rep told me she was wrong. Confused! I am. So I was informed that Aetna would have never accepted the information for review from Dr. Roslin's office if it was not covered. And as of 6pm last night, still pending. I am so anxious and time is flying. I quit smoking for the surgery and REALLY NEED a CIGARETTE to calm my nerves. ANy suggestions. Gail

Hi Gail, You should call Aetna and speak with a supervisor and if that does not help talk with the manager. I come from this background and sometimes that is what is needed. As long as you have co morbilities i.e. diabetes, hypertension, sleep apnea and meet all the criteria they should approve you. Be persistant. When I was quiting smoking (12 years ago) I would do activities that I would not smoke with, such as cleaning. Boy was my house clean. HA . Good luck to you and take care. Let me know how it goes with Aetna. My surgery is set for September 16. YEAH

Thanks that what I will be doing Monday morning! I am getting super duper anxious! lol Gail

Gail... What date does your letter say they have to tell you by? They MUST give you a date by which they MUST tell you. With both my rounds with Aetna they told me 2 days before their deadline. Good Luck! Erin

Hi, You see Aetna has not sent me a letter. They refuse to talk to me, other than it's still pending. They will only talk clinical to clinical- they are making me so mad- I am the patient, I pay for my coverage they should have some consideration . Thanks I will be on their a** Monday morning! they will probably get a restraining order againt me lol

Ok Gail here is the deal with Aetna.. They have 45 days from the time they recieve your inital request for coverage in which to give you a determination. You can talk to Member Services, but your best bet is to call Pre-Cirtification. Ask who exactly is your nurse reviewing your case. Ask to speak to them. If they won't let you ask to speek to a Supervisor and if they won;t let you keep going up the chain of comand till you get someone who will talk to you. I'll be honest I got the best help and the most symapathy from Member Services. I guess maybe casue I cried the most to them... And honestly I called daily.. sometimes 2 even 3 times a day! Im not convinced harassing them helped, but I also don;t think it hurt. Be prepared to spend 15-20 mins on hold at a time. I think they hope you will hang up.. but DO NOT HANG UP! Good Luck! Erin