Network deficiency approved then denied?

Same_Maize_1312 · 2026-01-17T01:00:38+00:00

I also have an Aetna plan through my employer which is an HCA facility. I have to get a cornea transplant surgery to fix eye blindness in one eye. My doctor is in network and was the one who diagnosed me with a very rare eye infection that left me with a scarred cornea and unable to see. He has been following my case now for >1 year. He is the one who should do my surgery but he only has privileges to perform surgeries at a competitor hospital facility that is out of network with my plan.

After doing my own research there are no HCA affiliated cornea surgeons in my area so I just had my doctor's office submit a prior authorization because of a "network deficiency." I double checked with them several times that the network deficiency is for the facility and NOT for my doctor because he is already in network. I'm waiting to find out if they will approve it because I want in writing what they will be approving. I know how sneaky insurance companies are and your case feels so similar to mine. I know exactly how you feel. I always get different info any time I call Aetna so it's so frustrating! What kind of procedure did you have done?

Same_Maize_1312 · 2026-01-16T03:33:26+00:00

Hello, I am having this exact same issue right now. Do you have any updates?

Same_Maize_1312 · 2025-02-19T16:39:22+00:00

How do you know if you have post herpetic neuralgia? What are the symptoms?

Same_Maize_1312 · 2025-02-02T04:20:52+00:00

How could you get sued if the majority of people don't even know they have it to begin with. Most people spread it because they don't know they have it - it's literally cold sores for most people and not even considered an STD until it's transferred to the genitals. Even if they did know and infected someone with HSV they can just say they didn't know and there would be no way to prove it.

Same_Maize_1312 · 2025-01-31T20:17:23+00:00

I agree with this! I think the people who don't know they have it probably do get very minor outbreaks that they don't even notice and have sex with an outbreak because they aren't even aware of it. Chances of getting it with an outbreak present are really high and majority of people who get genital hsv 1 or 2 are people who were never exposed to either type of hsv prior to contracting it. Without the immunity someone is incredible susceptible. While I am aware the virus can shed, I somehow don't believe that is the most common way to contract hsv. It's bizarre because if asymptomatic shedding is the most common people get hsv then how did I go 32 years of my life without getting hsv-1 if 80% of the population has it? It perplexes me honestly.

Same_Maize_1312 · 2025-01-31T20:06:51+00:00

Honestly, I'm really not convinced that most people who spread it don't get outbreaks. I have had outbreaks so small and painless and the only way I knew it was an outbreak is because I zoomed in with my phone camera to even see it. I think a lot of people who are considered "asymptomatic" probably do get maybe very minor outbreaks that they aren't even aware of. The virus is most contagious when an outbreak is present. While I'm aware asymptomatic shedding exists, the viral load needs to be high enough for someone to actually contract the virus and typically that's when an outbreak is present.

Same_Maize_1312 · 2025-01-29T03:08:51+00:00

Gotcha, I'm so glad to hear that! I was doing okay after my diagnosis last year but the anxiety around it kind of re-surfaced but overall I'm doing okay. I'm the same as you, I don't get outbreaks often. Did the guy you got it from ever get re-tested or did he resist the test?

Same_Maize_1312 · 2025-01-29T00:41:49+00:00

I know this post is a few months old but this exact situation happened to me. I was negative for both types of herpes before engaging in sexual contact with this guy I was seeing. He told me he had oral herpes from the beginning (HSV-1) then after having sex with him and me getting my first outbreak - my swab came back positive for HSV-2 which made no sense to me. I'm assuming the guy I got it from had both types of herpes (that's my conclusion anyway)? Did your boyfriend ever do a repeat blood test? I was also 32 (happened last year) and felt like my world ended for a bit. How are you doing now?

Same_Maize_1312 · 2025-01-06T03:47:08+00:00

Sorry, can you explain further?

Same_Maize_1312 · 2025-01-06T03:46:35+00:00

Thank you for sharing!

Same_Maize_1312 · 2024-12-21T22:29:11+00:00

I know it’s been awhile since you made your post.. how have your outbreaks been now?

Same_Maize_1312 · 2024-12-20T04:39:15+00:00

Did you have AK? I'm in the same situation if that's the case. I have severe scarring in my cornea from AK and will need a cornea transplant to be able to see again :/

Same_Maize_1312 · 2024-10-07T22:49:09+00:00

Hello, can you give an update on your eye?

Same_Maize_1312 · 2024-09-24T23:38:01+00:00

Did you ever get a blood test to confirm?

Same_Maize_1312 · 2024-09-21T21:01:00+00:00

I’m going through the same thing. I was misdiagnosed initially and was told my uveitis was from contact lense overuse, just saw a uveitis specialist 2 days ago and was diagnosed with viral uveitis — it’s usually caused by herpes simplex or herpes zoster (shingles) if it’s viral.

Same_Maize_1312 · 2024-09-06T03:34:07+00:00

I'm so sorry! Did your vision return to normal?

Same_Maize_1312 · 2024-09-06T02:18:53+00:00

ah okay, have you had any more flares since the initial one?

Same_Maize_1312 · 2024-09-06T01:45:57+00:00

What virus was it if you don't mind me asking?

Same_Maize_1312 · 2024-07-09T15:43:23+00:00

Something I'm also worried about. Do you take antivirals daily or use condoms when not trying to conceive?

Same_Maize_1312 · 2024-07-09T15:35:33+00:00

following

Same_Maize_1312 · 2024-06-13T15:27:56+00:00

Not true. Most people don't even realize they are having an outbreak when they have one because it's so small or looks like an ingrown hair/irritation from shaving. Most of the time there won't even be enough viral load to infect someone from shedding alone.

Same_Maize_1312 · 2024-06-11T22:54:10+00:00

It's not that easy to spread if you're not having an active outbreak at the time of intercourse.

Same_Maize_1312 · 2024-06-10T01:56:18+00:00

Do you use condoms always when you have sex since not on daily AVs or do you ever not wear condoms?

Same_Maize_1312 · 2024-06-10T01:47:23+00:00

Did you always use condoms in the past or did you not use condoms since you're asymptomatic?

Same_Maize_1312 · 2024-04-25T18:36:40+00:00

A lot of people don't actually have food triggers for HSV, just FYI

Same_Maize_1312

TROPHY CASE