Angry/discouraged/sad over letter... DENIED
After numerous denials with Cigna, I had Cigna supply a Case Manager to assist me in my appeal and approval process. You need to get an exact outline as to how Aetna wants their submissions to be done. Do they require a 6 month Supervised Diet program?
Get Aetna to fax or email you what the stipulations are for WLS and the guidelines. This will help in submitting your appeal. Make sure "YOU" stay on top of everything that is being submitted to Aetna. Just don't assume that when paperwork is submitted, that everything is being submitted exactly. They, the insurance companies, do not like to piece together material being submitted. Also, you surgeon can call Aetna and can do a telephone appeal to have this overturned as well. I've seen that happen to others, not me. I had to FIGHT and it was well worth fighting for.
Get Aetna to fax or email you what the stipulations are for WLS and the guidelines. This will help in submitting your appeal. Make sure "YOU" stay on top of everything that is being submitted to Aetna. Just don't assume that when paperwork is submitted, that everything is being submitted exactly. They, the insurance companies, do not like to piece together material being submitted. Also, you surgeon can call Aetna and can do a telephone appeal to have this overturned as well. I've seen that happen to others, not me. I had to FIGHT and it was well worth fighting for.
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