Question:
Can anyone give me any advice on how to get a quick approval?

Does anyone who has Aetna HMO have any good ideas about how to speed up the approval process? I am just so excited about having the surgery that I would like to make sure that the insurance does'nt drag their feet. Any info that I can provide for the doctor to make things go more smoothly? Thanks, Vicki M.    — vmize (posted on October 16, 2001)

October 16, 2001
Vicki, hiya, I have Aentha HMO even though I've been paying for my cobra since sept 2001. It all depends on your surgeon's office and how good they are about preparing and handling the submission.. i.e. stating things in a manner that will push things along without alot of questioning on Aenta's side. Personally, Aetna approves the quickest of most of the insurances out there. I know it seems like forever and I was waiting and realized after speaking with my surgeon's office manager that she hadnt submitted my approval letter yet because there were so many demands for the surgery and she hadnt gotten to the Oct/Nov surgery date group, my surgery is Nov 1st. Well she called me on a Tuesday and said she had faxed off the letter to Aetna. Called me that friday of the same week and said "You're Approved" So hang in there. It will come if you meet Aetna's requirements and also I learned from an inside source, it also depends on the claims review person. They review and then submit it to their medical reveiw board. Hopefully you will have a short wait. Maybe a week, could be two but for me it was 4 days. Good Luck Vicki
   — Gwen M.

October 16, 2001
Hello...While I dont have Aetna....I can still tell you just to nag...nag...and nag some more and dont let them forget your name! I work in the insurance field and know first hand that this works. I was approved in less that 48 hours...Just get to the right people at the insurance company and always stay nice and sweet. You dont want them to dread hearing your name....And go to the Utilization Management dept. Thats were youll get approval from. Good luck and keep me posted! Melissa
   — Melissa S.

October 17, 2001
I didn't have Aetna, but what I did was find a surgeon within my companies network, called them and made and appt. Then I got my referral from my PC and looked on this site under insurers to see what was needed for approval. I did those things (Psych eval, consultation, list of past diet attemps, list of comorbities, and a personal letter that I wrote on my behalf.) I was approved fairly quickly. I had my initial consult on May 15, 2001 and had surgery on July 20th 2001. If you would like, read my profile, I have all of the things I did written down. And alot of frustrations too!
   — Dawn H.

October 17, 2001
I found that the easiest way is to get your PCP(my Surgoen wouldn't even give me a consiltation until I had approval) to create a letter of Medical Necessity, and then Nag the hell out of the Insurance Company. In my case I didnt have to do any nagging. they approved me in 3 days, but have read many posts on this site that say to just nag nag nag. Call everyday. get specific peoples names, and extensions, and call them back Personally everyday. Remain vigilant, and you should be okay. I have also heard alot of good things about Aetna, but the policies can change from company to company depending upon what stipulations they chose for the Policy. Hope this helps!
   — sbinkerd1

October 17, 2001
I also forgot to mention... Check with your HR department, sometimes they can do some pushing to help you out.
   — sbinkerd1