Aetna Denied

I have Aetna Insurance and was told by my Surgeons office that I have been denied.  I still have two appeals.  It was odd because I called about two hours earlier and was told the they had received the information (71 pages) and it had been entered into the first system but that it had to be entered in a second system before it went for medical review.  The surgeons office called a couple of hours later and was told the request was denied and that a letter has been sent.  Has anyone had success after being denied by Aetna?  Is this typical?    Right now I am a little sad but not defeated.  I have done all the pre-requesite stuff they asked for so... I was trying for the three month approval has anyone out there ever succeeded?   

I have eatna but Im still going thru the preapproval stuff now. I have a question for you though. did you do the 3 month supervided diet or did you have 6 months of diet history from your PCP?

I went through the 3 month supervised by my surgeons office.  They had me see the Dietician and PA there for three months.  I called Aetna today and they told me I don't meet the criteria for surgery.  Over the past five years for only two of them have been over 40 BMI.  I have been above 35 for all five so I am going to wait for the letter and see if ObesityLaw.com will take my case.  Maybe I am not sick enough from the complications associated with obesity yet.

Aetna pays on appeal.  You have to read your denial letter and policy to make sure what you're being told is correct.

Another question what type of documentation do you provide as far as the exercise part of aetna requirements?

I kept a daily log of my activities and discussed it with the psycologist, PA and Nutrionist.  My log was submitted with my paper work.

I have Aetna and was just approved today for the surgery.   I went to see my Dr for the first time on 7/18/07.  I had all my paper work done already and they sent the papers to Aetna and was approved today 8/2/07.  My surgery date is 8/28/07. I heard a lot of companies to not include WLS on there plan so it is cheaper.  Did you call Aetna to find out if your plan covers WLS?  Good luck with your appeal!!!

I just got approved yesterday with my appeal through Aetna.   Aetna denied me in May claiming that  I had not been medically supervised.  I had sent 3 years of Weigh****chers plus my Dr. had been supervising me, but they claimed not enough.  After the denial I met with my regular Dr again and he wrote a letter stating everything he did and then sent every document proving Aetna wrong.  The surgeon's office revised everything and sent again.  I had some more tests results that I had taken since the denial.   I think this time they got so much paperwork that they couldn't come up with an excuse to deny.  They should have approved in May, but Aetna I believe will play games hoping that some people give up.  Overwhelm them with evidence and DO NOT GIVE UP!

Wow now im really worried because i am on the 3 month regimn they say you can do. Im doing the samet hing going to weigh****cher and seeing my Dr once a month. Plus I go to the gym. Is that not going to be enough is there something I can do now to prevent having to go through an apeal?

I have aetna and am not following a strict excercize thing.  That wasn't even mentioned. I am working with a supervised diet plan/nutritionist/dietician and have been since June 26th. Now I'm nervous...