PLEASE HELP big trouble lap band slip

I just found out that the reason I have been so sick is because my band has slipped.  So, making things worse I was a private pay and since I do have insurance now they say they are not sure that insurance will cover this.  Can anyone help?  Has anyone been able to just leave your band in?  Is it possible the band was never ever placed correctly?   I'm just lost I don't know what to do.  I can't pay to have another surgery. 

Often a band slip is cured by a complete unfill and rest period. Mine was. Have you tried that?

I wouldn't panic about paying for repair surgery until (a) you know you really must have it (having tried a complete unfill) and (b) you know for sure your insurance won't pay for the repair. I would think that your doctor can show your insurance company that repair surgery is a medical necessity and that your long term medical expenses will be enormous without that repair, they would be inclinded to pay for it if only to prevent future claims.

I know an OH member who worked in the insurance industry before she retired. Now she works as a patient educator and helps people (at no charge) who are having insurance problems. She gave me permission to post her contact info here. It's OK to tell her that Jean M. sent you her way.

[email protected]

Jean

Jean thank you so much.  I wasn't thinking about what the doctor needed to do.  I guess I just went into panic mode being sick and having insurance that they could ever turn something serious like this down.  I will take it one step at a time.  Thanks for her info I will contact her.  :-)

Lisa are you currently unfilled? If so are you having problems even though you are unfilled? If not, your slip is not urgent. It depends on the severity of the slip, if it's just pouch dilation, (a prelude to a full slip) then you may not need surgery, but if your band has truly slipped then you must have it surgically repaired or removed.

With small slips the first approach is to unfill the band completely and if you have bad burning you may want to have your surgeon put you on Reglan and Carafate and Protonix for healing and then start slowly refilling the band after 6 weeks see if the pouch shrinks back, but if the band is not in proper position you will have to get it fixed surgically. I would think if you NOW have insurance it should cover  costs to remove it  because it is life threatening and medically necessary to remove it, but to put in a new one that's another story. 

You may want to have your surgeon code it to fix and repair it at the same time, good luck. 

Thanks Nana this really helps a lot.  I really did jump the gun and just went off of the test I haven't seen my doc yet.  I'm sure it's all going to work out just got a little worried.

My insurance covered band removal because it was medically necessary. If your health is being impeded by the lapband, there is a good chance your insurance company will cover it. If they first say no, appeal.

If you're sick, don't just leave the band in. The damage resulting from a band in the improper position can be horrible.

Have you been unfilled, I assume?

Best of luck to you. I hope it all works out.

Thanks N.M. I just got my unfill.  Once again I really did react very fast out of fear and all of you have helped so much.  Thanks again :-)

 
I'm so sorry to see this post.  This is why I never suggest self pay for banding.  :o(

There actually is a way to get ins to pay for band REMOVAL if you do not have WLS benefits.  You pre plan a time with your doctor to go to ER and he admits you through the ER.  Then ins isn't an issue, it's considered an emergency and it might be a battle but ins will pay.

If you do not have WLS benefits on your ins plan they do not have to pay to reposition it, but they do have to pay to remove it in an emergency.

Slips don't mean it was placed incorrectly, it's a risk of the surgery type.  And the stats are on the rise for slips, not decreasing. :o(

Have you tried unfilling it to see if it goes back into position on its own?  85% of the time that is the fix for a slip.  It does not always require surgery.

Thank you for this information.  My doctor is great so I figured it wouldn't be him.  They did explain that this sometimes happens.  They did call me and it looks like it will be covered just waiting for the offical approval.    It would be great if I'm one of the 85% and it will fix it self and I don't need another surgery.  Thanks again :-)

Definitely talk to your doctor first.  then talk to his/her unsurance people in his office.  they deal with these things all the time.  The only problem mught be if your insurance has a pre-existing clause in it.  they may consider the fact that the band was placed before you were insured and not want to pay.

but most of all, do not put the cart before the horse.  take a deep breath.  Call your surgeon, ask to speak to his insurance experts and let them do the wotk.  most of the time they will deal with the insiuance companies for you.  they will also get a lot farther than you will.  keep us in the loop.  Have you scheduled an appt to see your surgeon?  has he/she confirmed that it is slipped?