Insurance Review after approval?

[Dopesaint]

I got a letter saying I was approved by Aetna for upper and lower jaw surgery (genioplasty not covered)

2 days later I got another letter in the mail saying “in order to complete our review and make a coverage determination, additional information is required” with a small list of things like letter of medical necessity.

A copy of the letter was also forwarded to my surgeon.

Is this normal? I thought it was approved could they cancel it?

[Post bimax]

I got a letter saying I was approved by Aetna for upper and lower jaw surgery (genioplasty not covered)

2 days later I got another letter in the mail saying “in order to complete our review and make a coverage determination, additional information is required” with a small list of things like letter of medical necessity.

A copy of the letter was also forwarded to my surgeon.

Is this normal? I thought it was approved could they cancel it?

I’m guessing they are determining your reimbursement

[Dopesaint]

I’m guessing they are determining your reimbursement

Makes sense.

Do you think the "letter of medical necessity" is something I have to go out my way for or does my surgeon sort that out?

[Post bimax]

Makes sense.

Do you think the "letter of medical necessity" is something I have to go out my way for or does my surgeon sort that out?

This is something your surgeon should handle since you are not qualified to determine the medical necessity of a procedure.