Recent Posts
Topic: how long for bc/bs ny to decide
hey forum, just signed consent and was told to wait for my insurence to get back to me i have bc/bs prism epo plan how long do they normally take to answer?
Topic: RE: Tricare Prime Approval - North Region
Thank you and the same to you. I was so worried but it turned out to be a snap. I waited 2 days bc the mytricare site kept saying it was "in process" and nothing else. When I called the case manager she said "I'm just waiting on a date from your surgeon". It was freakin' fantastic to hear those words. I'll see you on the loser bench!
Topic: RE: Tricare Prime Approval - North Region
That is great news. I am hoping to submit the first of next week. Good luck.
Topic: RE: Any idea how long Aetna takes to decide?
My paperwork was submitted to Aetna Friday 2/18 and I just found out today at 11am that I was approved :)
Topic: Aetna Appeal Letter
I'm currently drafting up a letter for my husband's appeal to Aetna for surgery denial and am needing some help.
Let me tell the whole story so it's better to understand....
He began the process in Sept 2009, covered under my insurance which was BCBS. He need 6 months of weight management but he had to stop because we lost our insurance coverage. He was only able to do 4 months of weight management. His current employer covers the surgery, so he's back at it again. Last month was his first month back at it. From what the insruance counselor said, Aetna would consider the previous 4 months because it was all within a 2 year gap. (Aetna seems to have a mind of their own because they're denying that). Another issue was for some reason either his weight management history wasn't submitted or didn't get faxed thru in error because they're saying that they only have weight history from Sept 2009. I know that's incorrect because I'm a stickler with him seeing the doctor.
So I'm writing the appeal and am needing some assistance or input.
Thanks in advance!!!
Let me tell the whole story so it's better to understand....
He began the process in Sept 2009, covered under my insurance which was BCBS. He need 6 months of weight management but he had to stop because we lost our insurance coverage. He was only able to do 4 months of weight management. His current employer covers the surgery, so he's back at it again. Last month was his first month back at it. From what the insruance counselor said, Aetna would consider the previous 4 months because it was all within a 2 year gap. (Aetna seems to have a mind of their own because they're denying that). Another issue was for some reason either his weight management history wasn't submitted or didn't get faxed thru in error because they're saying that they only have weight history from Sept 2009. I know that's incorrect because I'm a stickler with him seeing the doctor.
So I'm writing the appeal and am needing some assistance or input.
Thanks in advance!!!
Topic: RE: I'M APPROVED!!!!
Thanks. Trust me it will go by so fast. Good luck with everything. If you ever need motivation or someone to talk to...I'm only a click away.
Topic: RE: I'M APPROVED!!!!
Congratulations! That's great news. I'm in the very beginning stages of getting this surgery. I can't wait until I can get up here and say: I'M APPROVED!
Topic: RE: meeting high deductible
I just wanted to thank you for your insight. If you find out any more info please write!
Topic: I'M APPROVED!!!!
I just received a call today....I'm approved. I meeting with my doctor on Thursday to schedule my surgery date. I am so excited. I know this is meant to be because everything has been smooth sailing.
Topic: Tricare Prime Approval - North Region
Hi, My name is Tampa and I received my approval today after two business days! I just wanted to say Tricare rocks and I am grateful that they approved me without a hassle. I'm scheduled to have my RNY at Inova Hospital in Fairfax at the end of March. Although it's right around the corner and I have a lot to do in a few weeks I'm glad because the other option was May. So clear a big spot for me on the losers bench...I'm kinda hippy right now......but that too will past!! Yeah