Aetna PPO-just denied

Hi Everybody. Just thought I'd see if anybody has Aetna PPO here in Ky that got approved on 1st appeal. I had a book of stuff I sent in the 1st time, but haven't got the reason for the denial yet. I was denied 11/12/03 but am trying to get info together now to appeal. The new guidelines from Aug 03 say that you can send in for predetermination after 3 mo diet/excercise plan as long as surgery not scheduled-after approved-till after 6 mo period. I sent in my paperwork after 4 mo period. They req additional diet history which I then sent at 5 mo, and NOW they have denied. :' ( Is there a certain time frame to get things in for approval (poss 30 days??). Also, do THEY have to give me an answer within a certain time frame. Aetna will NOT give me the answers to this over the phone. I hope I can get approved ASAP as hubby off 1st week in Dec and it would be nice if he could be off with me. He could chg this to 3rd week in Dec if needed. Any/all info on Aetna PPO and how you got approved will be greatly appreciated. Thanks to all in advance.

HI Rebeccca, I'm sorry you were denied. I don't have Aetna but I'm sure that your time will come. Just keep trying and know that everything will happen in God's timing. I'm praying for you. May God Bless YOU!! Jill

Thanks for your reply (and prayers). Sometimes I feel so alone on this Ky board as I hardly ever get but one or 2 answers to questions I ask. Don't mean to be grumpy, but when you put a ? on and especially one about insurance, you HOPE to get answers. I wish more Ky people would get on here (especially Louisville ones with Aetna) so I could know what I'm up against in this area. I really appreciate you answering. Are you looking into surgery? have had surgery? or waiting to get approved? Just wondered. Please don't take my griping as something against you, because it isn't. This waiting game with insurance companies is SO HARD....... Have a good night! Becky (nightshift/night-owl)

Hi Rebecca, Don't get discouraged. I can't say I understand because my insurance was approved on the first try (see my profile). But I can understand how it would be upsetting. Just stay strong and it all work out according to God's plan. Jill