Insurance HELP for VSG needed - PLEASE!
Any help and advice you can give would be appreciated.
I currently have a Lap Band and I am on my third slip (long story but in short version I slip every time I have restriction and get sick) so the Band has to go before it harms my stomach. (Those are my surgeons words.) I have had the Band for 2 years and have lost and kept off 50 pounds even though I have had very limited use of my Band for the entire time.
I have researched VSG and feel it is the best for me. I am terrified to have my intestines manipulated and don't want the complications associated with malabsortion so VSG sounds like a perfect fit. My doctor does VSG, but insurance has denied. My doctor is going to do a peer to peer talk with Anthem Blue Cross and Blue Shield, but he is not hopeful that they will reverse their denial. Is there anything I can do in addition to his peer to peer or information I might be able to give my doctor? I don't want to do anything that might inhibit his ability to get my denial reversed, but if there is anything I can do to assist in approval I would like to do it.
Another factor is my surgery has to be done within a few weeks due to my work schedule and the Band rubbing on my stomach.
Any help or advice is greatly appreciated!
Donna
I currently have a Lap Band and I am on my third slip (long story but in short version I slip every time I have restriction and get sick) so the Band has to go before it harms my stomach. (Those are my surgeons words.) I have had the Band for 2 years and have lost and kept off 50 pounds even though I have had very limited use of my Band for the entire time.
I have researched VSG and feel it is the best for me. I am terrified to have my intestines manipulated and don't want the complications associated with malabsortion so VSG sounds like a perfect fit. My doctor does VSG, but insurance has denied. My doctor is going to do a peer to peer talk with Anthem Blue Cross and Blue Shield, but he is not hopeful that they will reverse their denial. Is there anything I can do in addition to his peer to peer or information I might be able to give my doctor? I don't want to do anything that might inhibit his ability to get my denial reversed, but if there is anything I can do to assist in approval I would like to do it.
Another factor is my surgery has to be done within a few weeks due to my work schedule and the Band rubbing on my stomach.
Any help or advice is greatly appreciated!
Donna
Donna after the peer to peer review if you dont get a reversal, I suggest that you proceed with an appeal or possibly contact www.obesitylaw.com to see if maybe Kelly or her husband can help possibly fighting to get approved.
If you need some help with appeal letters and research info, it is in my blog. I hav BCBS and they denied the sleeve saying it is investigational. Your surgeon probably has a very good chance at getting it approved. Most band slippage patients can't have RNY because of stomach issues so the only option is VSG. Good Luck to you
"There is a skinny woman trapped inside of me. I can usually shut her up with cookies and chips but today I am setting her free"
Most Active
Recent Topics
My insurance will not pay for my excess skin that hang down to my knees
Hockeymom87 · 0 replies · 604 views
Hockeymom87 · 0 replies · 604 views
