CAN ANYBODY HELP ME W/AETNA PPO??

Dr. Bosquez' office faxed my info last Monday, the 24th. It has been recieved and reviewed by a man named Rogan, who is sending it up to his Medical Director who will approve, or deny. He said the only thing that could hold it up, is my 5 years documented examples of over 40 BMI weight. They are not from consecutive years, they are from 1995, 97, 02, 03, and 04, plus one of those years, the example I gave was at 39.something BMI. Am I screwed????? If anybody has dealt with them, can you please give me some advice? Rogan said I should be hearing something on Tuesday. Thank you, Jeanine

I have aetna PPO. They will almost always deny on the first pass. It will be up to your Dr and you, and will depend on how dedicated you are to getting the surgery. They denied me, and my Doctor's office called them and they approved me that same day. I know that they do not like to approve the VBG, and will give you the most hell over that, mostly because the VBG allows the option to "cheat" and maintain or even gain weight after the surgery. And, VBG'ers almost always have a revision to an RNY anyway, so they prefer to just pay for that surgery first, rather than pay for the VBG now, and then the RNY later. They specifically told my Dr that they would approve me for RNY only, and would not consider the VBG. So, it may depend on which surgery you are having.