Aetna, be prepared - that's the key
I had to file 3 appeals with Aetna prior to my very recent approval. My MD filed first request. I retained obesity law to file the 2nd appeal. I asked Payam Shayani to hold off on filing the appeal until receipt of the new medical information. He charged $500 and didn't wait so I was denied again. I can't blame Aetna for this denial. They were specific in their needs and I had the information on the way to Obesity Law but they went forward and filed anyway. They just took the $500 and said "what do you want me to do". Payam Shayani said "I'm not in the business of ripping off people". Who, other than himself, said he was? I do now. I filed my own appeal and was approved in 4 days time. The key, be prepared. I filed a letter asking for reconsideration and went into detail of the health problems I experience. I then added a table of contents of all information attached. I tabbed each section. I then highlighted all the medical records, highlighted weight, year, any indications of high blood pressure, heart palpatations, meds taken for weight loss as well as for the health issues. I added my weight chart, my weight history of diets, etc. It looked like a well prepared submission and it worked. Who needed the lawyer? I would recommend everyone try this before engaging legal counsel that will just take your money and not listen to you. He could have been a hero had he waited for the information, instead he cashed the check, changed the names on his pleadings and submitted. Obesity Law was of no help whatsoever.