UHC-Bummed and Angry with Denial for Revision

Hi All, I am so bummed that I was denied my revision.  I am getting all my ducks in a row and have a call into Gary Viscio for my appeal.  I was hoping that I wouldn't have to do this, but kind of suspected it since my BMI is not 40.  I am like 38.1 so I am 9 lbs underweight.   I was told they don't have criteria for revisions.  How do we know what to do from here?  I am not giving up so easily.   I called the Gi Dr. and he told me he won't write a letter for my appeal.  He's the one that sent me to the surgeon in the first place, now I am mad.  He said to talk to my PCP and the Surgeon.  Who does he think I am working with!!!! If any of you can come up with ideas, let me know.

Deanne- UHC has a Bariatric Policy on their web site. It is REALLY hard to find so I copied all down one day. I can email it to you if you PM me.



I believe it says that you don't have to meet the same criteria for revision that you did for the original surgery. IOW, you should be able to have a revision even if you are at goal! But I'm at work and can't look it up.



That doesn't mean that they won't deny your revision for other reasons. One reason they mention is that they don't pay for a revision just because you haven't made it to goal weight. There has to be some underlying fault with the original surgery you are trying to correct. Like if your lap bad erodes, or your RnY pouch stretches too much. Things like that.