Peer to peer review

My doctor submitted to Aetna on 10/1. I called them today and they said I was denied due to not having a 5 year history and documentation about the sleep study submitted. I called my doctor's office and she is totally shocked. She said she faxed over 108 pages of documentation. Including the sleep study. She also said I had 5  years of history. She said it was one of the most complete records she has yet to see. Apparently they didn't spend much time looking through my 108 pages of records. The rep with Aetna told me that she spoke with someone in the pre cert dept and they said that my doctor is to call for a peer to peer review. Is that a better option than going for the appeal? I'm guessing we can still appeal if the peer review doesn't work. This is quite frustrating.

A peer-to-peer review is neither better nor worse than an appeal, but it is a shorter process, so I would go with the review first.  In essence, a peer-to-peer review is nothing more than a discussion that your doctor has with the insurance company's doctor to, ideally, achieve a meeting of the minds.  It's more personal and definitely direct considering the bureaucracy that one can go through with insurance companies. And, as you stated, if the peer-to-peer review is not successful, you will have the option to appeal, but I think the peer-to-peer review will adjudicate in your favor if your doctor is specific and forthcoming with why you need the surgery. I hope I was able to answer your question.