Aetna Open access select members (approval rate?)

what is the success rate in approval through your insurance for gastric bypass?

I am in the process now of my 3 month multidisciplinary program through Centennial, and was wondering if anyone has been through this and is aware of the approval rate and process?


Thank you

Jennifer Adams

hubby and I had Aetna at the time of the surgery.  We were covered by the hospital,  but not by the surgeons at Centennial.    We were both approved fairly quickly after the 3 month thingy was complete.

I have Aetna (not sure the exact program, but requires all to be in network for coverage).  Once I completed the 3 month requirements, support group, Psyc eval, etc, and once submitted, I was approved in one week.
A co-worked for the same company had surgery the same day I did and his was approved just as easily.

If you qualify and do what is required, I do not see any reason they will not approve you.  The only time that I've seen problems, is not all the required information was submitted, or there was some sort of exclusion.

Michael.

thanks for this info!!! Ive heard so many horror stories about approval, I was starting to worry.

Ive already got a 5 year record of my weight from my PCP and a Letter from my PCP

Ive went through my support group, I go tomorrow for my Physc Evaluation

and then Friday starts my 3 month multidisciplinary program through Centennial.

So I guess we will see

Hi Jenny,

I have Aetna Open Access when I applied to have the gastric bypass and I was approved within 3 weeks after the doctor offices sent them all the necessary paperwork.  I eventually changed my surgery to the Lapband and even then I had not problems.  I wish you luck!!

Lisa

I don't mean to be nosey  but I have Aetna Fed (VA employee) and have been approved for the Lapband. I am relocating to Memphis due to work changes. My question is...... did you have to pay any  out  of  pocket expenses to your Surgeon or the hospital? What hospital/surgeon did you use?

Here in Little Rock, AR the hospital is requesting I pay a $1000.00 deposit. Since I'm a recent graduate from school, I don't have that type of money  available, just now. The Surgeon did not inform me of this until it  was time for my  surgery.   So I'm in a holding pattern until I move.

I have Fed Aetna too.  I work for the dept of Navy.  My doctor is Dr. George Woodman and had my surgery at Baptist East.  Dr. Woodman requires a $500 fee that is not paid by the insurance company and I had to pay the outpatient copay the day of the surgery.  Dr. Woodman will let you make payments on the $500 as long as it paid before surgery date.    Dr. Woodman is an excellent surgeon but he is very straight forward.  

Let me know when u get to Memphis and I will do what I can to help you.  My home email address is mzmom67 @ aol.com and my work email is melissa.boles @ navy.mil.  

Lisa

THANK YOU SO MUCH!!
Perhaps it is just the hospital i was trying to use it was, Baptist Medical Healthcare System. I could deal with a payment plan but not a give me the money right how plan.
I will be contacting you as soon as I can find a place to stay in Memphis. Waiting on job interview with the VA but I also applied at the Dept of Navy for a RN position...good to know they have Aetna also. My info is [email protected]  and [email protected]

Let me know when you get here and I will give you my cell number and I will try and show you around.  Just email me anytime.  Right now my computer is not working but I should have a new one by next Sat.  So just send me an email at my work email ([email protected]).  Keep in touch and I will do whatever I can to help you.

Lisa

i gain and have try everything possible. I need to lose the weight due to the edema of both ankle, wrists and the constant out of breathe. I have open access and i pray they do not give any problems. I want to get my self back into a healthy environment. Please let know how the surgery went?