Anyone with BCBS Federal get approved for a revision?

Virgie Tschirhart
on 9/20/13 12:26 pm - Midwest City, OK
RNY on 12/27/17

I am planning to get revised from a Sleeve to the RNY.  I had a Lap Band and it did not work out for me in April 2008, BCBS Fed did approve the surgery of the LB.  In May 2009 I had the LB removed and got a VSG.  Insurance only paid for the removal of the LB not the Sleeve.  I had to pay cash for the Sleeve.  

So now that I realize that I should have never chosen the LB or the Sleeve.

I have a haital hernia which gives me severe acid relux!  I know the RNY would be the best choice for me. 

Please tell me did BCBS Federal approve you for your revision?  How far apart were your surgeries?

 

Thanks.  

Virgie Tschirhart

Lap Band - 2008, Sleeve - 2009, RYN - 2017

Started Program Weight July 13, 2017 - 194.2

Before Surgery Weight December 27, 2017 - 185.0

Current Weight - February 2018 - 161.0

Amanda W.
on 10/3/13 12:39 pm

Mine was approved today by BCBS FEP Standard.  My surgeries will be slightly more than 4 years apart.  Band to RNY.  I already had my band removed, they approved that within 24 hours.

 

The guidelines are in the benefits book.  They are being VERY strict...they tried to catch me on non-compliance to the previous program, but my surgeon had enough notes to prove how involved I've been.   My insurance coordinator said that they are pouring over revision requests with a fine-tooth comb.

Virgie Tschirhart
on 10/4/13 2:53 am - Midwest City, OK
RNY on 12/27/17

That is wonderful!  I'm so happy for you. 

I went to my first appointment on Wednesday.  I have to do the Psychiatrist and Diatician appointments before they turn in the paper work to the insurance.  I know what you mean about how "strict" BCBS Fed is. 

My doctor said that I should have never had the Sleeve done, because that did not help my Haital Hernia.  I have horrible Acid Reflux he says it can eventually burn through to the lungs and then it could be fatal.  I have Diabetes Type II, Hypertension and possible Sleep Apnea, waiting for my results on that.  So, I'm not sure what will rule being that my surgery was 4 years ago?  Or will they just say no because I was non compliant.  The Sleeve did not work for me. 

There was a study done about 3 months ago or so.  It was discovered that quite a few Sleevers develop a hunger for sweets, even if before surgery they did not care for sweets.  That is me! 

Thanks for sharing with me I really appreciate your input.  Best wishes to you Amanda!!! 

Virgie Tschirhart

Lap Band - 2008, Sleeve - 2009, RYN - 2017

Started Program Weight July 13, 2017 - 194.2

Before Surgery Weight December 27, 2017 - 185.0

Current Weight - February 2018 - 161.0

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