And now we play the waiting game.

I have everything done that my insurance/surgeon requires to have RNY..In the passed 3 months I have Gone to a heart doctor Gone for a stress test Gone for an upper-endoscopy Gone to a pulminologist Met with nuitritionist (2 times) Met with surgeon Went to my psychologist, 3 times. Went to support group Went on a 3 month diet, documenting everything I have eaten Now I must play the waiting game. How long should I expect to wait? Both my surgeons nurse and the nutritionist have had nothing but good things to say about AETNA insurance and that they are usually very good about approving things if all conditions are met. Also, has anyone on here had RNY done by Dr. Michael Bono from Hazleton PA?

Hey,  I don't have Aetna....but I can tell you, make sure you follow up on things.  My surgeon sent in my paperwork and the insurance said it would take 10 days to make a decision.  I called just about every day, and they kept saying it's not in the system yet, but it would show up once the decision is made.  On day 11, I finally spoke with someone who had a brain and they said "oh, we never received it"....so I had to have the surgeon fax it in a 2nd time.  This time I called the same girl ever 2 days, and she was really cool because she had already gone through the RNY surgery.  She finally confirmed they received it, but it took 20 days to get the approval.

Also, read your policy or call them and ask them what their contracted timeframe is to pre-approve a procedure.  Follow up with them and make sure they received it and that they are processing it.

As far as insurance specific, if you go to the Insurance board, there is a link there to a listing of all the insurance companies and what the OH user's have said about them.  I found some companies are rather unimpressive to work with, while others are very impressive.  It's worth taking a look at.

Good Luck!

Thomas

This is the part that really blows.... make sure you keep copies of everything, so if you get "well, we don't have a copy of your xxx paperwork"...you can just fax it over immediately instead of waiting for another bunch of idiots at another office to do it on their time...stay on the ball...it's a rough wait...but so so SO WORTH IT!!! good luck! xxxBecca

My journey from submittal to approval was I think, 13 days...My insurance is United Healthcare...I called them every day to check, around the 11th day someone asked me if I wanted them to place the file on "expedited status" and I was like "expedited status? I didn't even know I could do that, heck yeah!" that afternoon I got a call saying they needed a five year weight history which I got them in less then an hour, and withing 48 hours they called me (because I had asked them to) to tell me I was approved. Less then three weeks later it was time to roll.

It took my insurance 2-3 weeks to approve.  I like what another poster said - make sure you have copies of all of your paperwork so your insurance company can't play that game.  And CALL.  I called pretty much every day to check my status, so I was a pain in their butts.  When you call, be polite, write down who you speak to and what they say, and let them know you will call back.  I hope this is a quick process for you!

By law your insurance has up to 30 calander days to respond to your request. My suggestion is to call about 5 days after the surgeon submits to ENSURE they have your paperwork and its being processed. Then I would call back once a week to check status.