Insurance Nightmare/Need Support

Hello, I have been reading posts on this board for a few weeks and have been inspired by many of you. I am in the process of getting a LapBand around my RNY and I hit a very large bump in the road. My insurance company is using the regular requirements for this surgery versus looking at it from a Revision standpoint. I know I have a battle in front of me... My doctor office is waiting to recieve the letter of denial, then they will call and figure things out. Its just the fear of never getting approved that brings me here for support. Thanks to all *****ad this..I need all the support I can get. Have a wonderful Day Molly

Molly, Who is your insurance company. I had Blue Cross. They said the same thing at first and then I read their medical policy pertaining to weight loss surgery and there are slightly different requirements needed for revision to a previous bariatric surgery. Ask for a copy of the medical policy or see if it is on their website. After a fight and an appeal, my revision suregery was approved. Why did your RNY fail the first time? My staple line ruptured on my first VBG surgery and I am revising to the RNY. Just curious to see what happened to your RNY. LEt me know how I can help. SK W

Molly: I know somewhat how frustrating and frightening this situation can be - not on the revision, but just waiting for insurance approval in general. Before I paid out of pocket for a VBG (that has now failed and I am trying to get revised to RNY), I was working with an insurance company to get RNY. They found every excuse they could to prolong the procedure, and in the meantime my workplace closed and I lost my medical insurance. So that was the end of that... All I can tell you is, get as much information about their medical policy as you can - the company website may list it, but you can also request a copy (by law, they have to provide it too you). Then, be willing to go the extra mile to fight it if they deny you. I wish I had been more aggressive when I originally had the chance at the RNY, but I didn't know enough to know what to do and the person in charge of my approval at the surgeon's office didn't do much to help me. Sounds like your doctor and staff are willing to pitch in to help you get this...They should be able to advise you as to what you can do (what records you can submit, etc) to help you get approved. You will certainly find support here. I did, when I was having doubts about myself due to my VBG failure. And I am sure I will again, when I am waiting to hear about my insurance approval for my revision. My thoughts are with you. I wish you all the best in this situation... RL