Denial due to non compliance??? Really!!

I had the lap band placed in May 2006, everything went well and I lost about 90 lbs.  I started to have pain at my port site and noticed I no longer had restriction so I went it have it checked out.  After the EGD it was discovered I have erosion.  All pre op requirements done according to fepblue, but denied due to non compliance.  So after 2 submissions to the insurance company now my surgeon has a peer to peer scheduled for tomorrow 1/2/14.  Praying everything goes well.

Anyone have this type of experience?

Sorry you got denied.  I have read other post of people with the same issues with their insurance co.  You might want to post this question on the revision forum as well.

Hopefully they will approval after the peer to peer.  Keep us posted.

Hi pharmagirl thanks and I will post in the revision forum.

how did the peer to peer go?

I did not go well.  After that I called the insurance company and they state the doc office is not submitting all information. 

I am going through the same crap. I had my band placed in 2003 and only lost about 20 lbs.. I had fills and unfills and never could get it right. it was either everything went down with no obstruction or completely nothing for the first 3 years with the band. Then, Went through lots of IVF treatments and had 2 kids then nursed both so for 6 years I couldnt have a fill in my band anyway. Went to the original surgeon who placed the band. (HIS OFFICE LOST MY ENTIRE ORIGINAL FILE!) Last 2 years started trying again to see if I could get the right fills level. This time the band started causing loads of pain. Turns out trying to get it filled the last 2 years caused a severe slip and it i****ting my diaphragm. So, fought Cigna for the past year and they finally agreed to pay for band removal but will not pay for revision to sleeve due to non-compliance. So Cigna is saying that I meet all the other criteria but until I produce that now non-existant record, they will not pay for sleeve. How are we supposed to argue with that? To say we were not compliant is an opinion, not a fact. I would saying trying for years and years to avoid surgery again and work with a sleeve that isnt helping, is compliance.