Give me strength! Pre-Cert Confused

I am tired and confused... I have been to two doctors, both agree that I am a good candidate for lap-band and my PCP agrees that after 6 years of diet pills and exercise bordering on the extreme that this is the best option for me. I left the first doctor because his staff was horrid at communication and getting my paperwork submitted to aetna or even telling me when they needed additional information. Now the second doctor's office has finnaly submitted my stuff to aetna only to have aetna send me a letter asking for me for documentation that should have been included in the submission. I gave them 5 years of doctors progress notes with medication, blood work, and weight history. They also have nutritional, lung, psych, and sleep reports. I even went so far as to send copies of all proof of exercise programs for the last five years. I don't get it! Is this normal for aetna to send a letter asking for stuff they should have gotten? Should I send in copies of the documentation that I have or should I hound the doctor's office to get the submission straightened out?

I'd send in the documentation yourself. I used to work in the medical billing field, and your info is probably in a long line wait for submission. Don't ever rely on your doctor's billing office personnel to do anything for you. The more you follow up/hound your doctor's office, they will get the message to get on the ball. Until then, send in the information yourself and start hounding Aetna to make sure they received it etc. Better yet, send it confirmation receipt requested, or certified etc to PROVE that Aetna recieved your information. Most insurance companies try their hardest to either delay or not even approve an expensive proceedure as this.

I agree with Jolynn, I have heard stories of insurance companies playing the run around with you in the hopes that you will give up out of frustration and then they win. Don't let them win. Kia

Thank you! I spent the better part of this morning trying to fax my info to a fax number that would not dial as long distance or as local. When I called them about it they claimed that it was the correct number. I then asked for a mailing address and they give me a po box in Kentucky and the letter they sent orginated in Alpheretta. I finally got the doctor's office on the line and they tell me that I need to give it until next friday before I get upset. They then complained that my file was larger than any that they had recieved. I thought it was vital to give them every bit of documentation.