Has anyone had a revision from VSG to RNY with Dr. Lana Nelson, OK?

Virgie Tschirhart
on 2/27/13 7:28 am, edited 2/27/13 7:29 am - Midwest City, OK
RNY on 12/27/17

Yes, Dr. Stewart in Denton, Texas.  What is your insurance?  Mine is BCBS Federal they would not approve me because my BMI was not greater than 50.  I did ask about self pay with Dr. Stewart for the DS,  they said the revision would be around $25K.  So much for that, I'm not RICH!

 

 

Virgie Tschirhart

Lap Band - 2008, Sleeve - 2009, RYN - 2017

Started Program Weight July 13, 2017 - 194.2

Before Surgery Weight December 27, 2017 - 185.0

Current Weight - February 2018 - 161.0

beanybaby
on 2/27/13 12:59 pm

APPEAL. That BMI over 50 bit isn't gonna fly. The requirements don't change, and they are the same for either surgery - BMI of 40, or 35 with co-morbs. 

Go to DSfacts and there are links to studies that you need to get familiar with, and may want to use some of that information in your appeal. Yes, the DS is most successful for BMIs over 50, but it's more successful for lower BMIs as well. 

Virgie Tschirhart
on 3/1/13 10:11 am - Midwest City, OK
RNY on 12/27/17

I'm afraid I already messed my self up with BCBS Fed because I was not in compliance with the prescribed nutrition or exercise, when I had the Lap Band in 2008.  They already denied me for the RNY back in 2011 because of those reasons.

Thanks.

 

Virgie Tschirhart

Lap Band - 2008, Sleeve - 2009, RYN - 2017

Started Program Weight July 13, 2017 - 194.2

Before Surgery Weight December 27, 2017 - 185.0

Current Weight - February 2018 - 161.0

Hislady
on 2/25/13 1:25 pm - Vancouver, WA

Way to go Babygirl, got my fingers crossed for you!!!

 

Virgie Tschirhart
on 2/27/13 7:45 am - Midwest City, OK
RNY on 12/27/17

BCBS Federal Insurance requirement "BMI must be greater than 50" for the DS.  

Self pay is $25K for the DS at Dr. Stewart's in Denton, Texas.  

 

Please no more negativity on the RNY, surely not every single RNYer has gained all their weight back and/or gets dumping, vomiting etc...  

I'm going to drop the DS and reach for the RNY.  

Thanks to all the Vets that have chimed in to give me your experiences and knowledge.

 

 

Virgie Tschirhart

Lap Band - 2008, Sleeve - 2009, RYN - 2017

Started Program Weight July 13, 2017 - 194.2

Before Surgery Weight December 27, 2017 - 185.0

Current Weight - February 2018 - 161.0

MsBatt
on 2/27/13 8:04 am

If you think you'll be happy with the RNY---fine. But given that you already have half a DS, I'd try appealing. Can you argue that you need to be able to take NSAIDs? What are your co-morbs again? And are you certain that Dr. Stewart understood that you only need the intestinal part of the DS? 25K sounds high for that. (I think Baltasar in Spain does just the Switch for diabetics for around 10K.)

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