Question:
Approval
My doctor's office called and told me they received approval from Aetna. I didn't get a written confirmation so I sent an e-mail requesting same. The return e-mail I received tonight reads: I am not showing a predetermination on file for gastric bypass surgery. Predetermination is not a requirement under your policy. Your plan does include benefits for this type of service, if you meet the medical requirements for this type of procedure. Gastric bypass surgery is subject to medical necessity. Please contact customer service at the number on your Aetna ID card if you have any further questions. The information provided is not a guarantee of coverage. Coverage is based on all the terms and conditions of your plan as well as eligibility at the time services are rendered. However, I called this morning and they gave me an autorizatoin number. Should I be concerned? My surgery is scheduled for Friday, May 9., — Katerina M. (posted on May 5, 2003)
May 5, 2003
I basically got the same run around, so I called them everyday and got the
authorization # given to me and basically I had the Surgeons office call
them and BCBS gave them the approval code, so I wish you luck, my surgery
is scheduled for 5-7-03
— WHENIMGONE72
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