2nd opinion...how does it configure in my approval?

Does anyone know how the 2nd opinion work with getting approved? Here's a recap of the situation: I was approved by the surgeon at my Managed Care group for VSG and the band, but he doesn't believe in any malaborption type surgery and was an asshole, so I requested to go outside my managed care group with Pacific Bariatric.

I called Pacific Bariatric to check the status of my file and low and behold my letter of medical necessity was faxed to my managed care group on 08/19/09! So I called my managed care group with the old surgeon and I was just told my case is in special handling. Well it's probably because managed care keep saying that it's not a covered benefit in my plan and then I sent over all the VSG denial letters that says we will authorize surgery but pick one that's covered! I am so excited to at least be this far, even if I do end up appealing I still like being this far. Plus I was told since my Pacific Bariatric appointment was for second opinion and the surgeon in my group refuses to do RNY that my insurance has to find me a surgeon that does RNY. I definitely don't want the previous surgeon to touch me since he was quite rude!!

Does anyone know how this will work since the previous surgeon agreed that I needed surgery but said either VSG or the band and I wanted RNY? My insurance says they will approve ANY surgery but VSG in so many words? Please advise.