What do I do?? Dr. Office no help....

Janet L.
on 3/23/09 6:20 am - Jemez Springs, NM
I have UHC and we put in for the VSG. I got denied cause they say it's an experimental procedure. The doctor's office says the way it's worded they don't think it'll get it over turned. So in other words he doesn't want to help with my appeal  major bummer huh... So what do I do?? Has any one had UHC and had a Sleeve done after an initial denial cause of it being  experimental?? My UHC covers the band and RNY I can get either one of those, but I do not want either one.  Please help
Thanks


Tammy_in_PA
on 3/24/09 1:23 pm - New Castle, PA
Unless you have a specific clause saying that the VSG is absolutely excluded, then it is fightable. You're best bet is to contact someone like Walt and Kelley Lindstrom at www.obesitylaw.com or you can check out an advocate that may be able to help you...   http://www.obesityhelp.com/forums/DS/a,messageboard/action,r eplies/board_id,5357/cat_id,4957/topic_id,3585831/


Good Luck
 Best Wishes,
Tammy                              

 

Entered Onederland 01-03-2010
Century Club  01-29-2010
Goal    06-29-2010
CaliMom
on 3/25/09 5:50 pm
 Have you considered getting the DS? The DS has the stats of excess weight loss and maintence. It does have more malabsorption than the RNY but that helps you to lose the weight and keep it off. You do have to be committed to taking vitamins and supplements with the DS and getting annual labs, but that's a small trade off to the quality of life you will be able to have after the DS. Check out the DS board for more info. I know that the DS is covered by UHC and isn't considered experimental.

That being said, if your mind is set on the VSG then all you can do is appeal and try. I know I've seen a few people on here get their denials for the VSG overturned. Have you tried posting on the VSG board to see if anyone there can help you? 
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