Aetna Appeal Letter

Sorry to hear that.  I guess your only option would be to have your doctor write a letter asking them to expedite the appeal process for dire medical reasons, and then explain the hernia.  Hopefully it won't take the full 8-12 weeks.  I wish you luck!

Hello there. I have recently "completed" or so I had thought the necessary requirements from Aetna to be approved for a the gastric sleeve surgery. I finished my classes at Ohio State Medical Center on July 27th. In 2011 and 2012 I did not take any trips to the doctor, I travel for work so because my last visit was in 2010 I was denied due to not having 2 consecutive years of proof of obesity. I was hoping to get some suggestions on what I can do in this situation. Thank you so much for taking the time to read this.

Sincerely,

Justin Tuttle

Hello,  we have Cigna...care allies and they have denied the claim stating that they are not in receipt of documentation under a physicians care for 3 months, supervised or registered dietician, or supervised weight mgmt for 12 months. This is not true, the bariatric surgeons office has submitted it and called them to verify receipt.  My husband is about 5'7" and weighs nearly 300lbs. He has sleep apnea, high blood pressure, and degenerative joint pain in his knees and back.  If anyone can assist, your advice/guidance would be greatly appreciated.

I don't know if you will get this. But I need help with my appeals letter!

Can someone please help me write my appeal letter?!! I have been denied because of my weight in 2011. I resubmitted new documents from my pediatricians office showing i was over 35BMI but they still are upholding their decision of denial. I am going for a second appeal now... SOMEONE PLEASE HELP ME !!! 

I didn't have to do an appeal, so I can't help you.  I'm sorry!  I just wanted to acknowledge you though.  I hope you find help!  Can your surgeon's office help you?  That is who usually helps with the appeals.