aetna-just wanted to share

[Guest guest]

I just wanted to share, that I spoke with my division of Aetna

USHealthcare Managed Choice today..I had to call about something

else, so I decided to ask about the coverage for bpd/ds--they told me

that it is a covered procedure, based on individual review &

approval. They recommended that I be sure that the doctor is in

network, as well as, the hospital--in my case, Mt Sinai & Dr Inabnet

are in network even though I live in Delaware--that way I would know

if I would have out-of-pocket expenses--in my case in network--pays

100%. Then I advised them that I am scheduled for surgery on May

11th & what could I expect for an approval time once my surgeon

submits the pre-certification papers & I was told 3days-1week. Also,

she told me to be sure that my pcp had completed the referral to the

surgeon for the specific procedure. So, basically, now it seems that

it is up to the surgeons office to get the paperwork to Aetna in a

timely manner to get the approval between April 23rd (consult date)&

May 11th (surgery date).

I have my endoscopy on Monday & will have the results in hand to

carry to NYC with me on the 23rd. It is hard to believe that by this

time one month from today I will be switched & might even be walking

the halls of Mt Sinai.(walking might be pushing it a bit)BUT..its

okay to be prepared.

ogretta

pre-op & ready

may 11, 2001 12noon

dr inabnet