insurance

ive been waiting three months for my revision... and now two weeks before im suppose to have the surgery they tell me my insurance denied me.... im so furious about this... has anyone else have problems with insurance before... the thing is im suppose to have my hernia fixed and take out my band and they wont even pay for that... so what am i suppose to be in pain....SO MAD.... UGH

Well, regarding the hernia, insurance is suppose to pay for that period. As for taking about the band and doing a revision ...maybe they think you don't need a revision?? But I would definitely fight for the hernia getting fixed if you are in pain.

well the reason they want to do the revision is because ive been having problems with the band i had problems with my asophicus i also have h pylori and they found gull stones.

Hopefully this information will help you.  I was converted from lap-band to gastric bypass after complications. The first time the insurance paperwork was sent through, the insurance company denied it. My surgeon had to call the Doctor the insurance company has to do a peer to peer review, once that was done and she explained the necessity of the surgery, the insurance company approved it. So definately fight it, but make sure you document everything, make the phone calls yourself to follow things up and make sure that people are doing their job. Asfar as the H pylori is concerned, that really has nothing to do with necessity of the surgery, H. pylori is a common microbe found in the gut and can be treated. There might also be an issue with the paperwork for insurance if the terminology used is revision verses conversion.  Revision refers to fixing the current surgerical procedure that you have. Conversion refers to removal or changing of one procedure to another.  Example, after my band slipped, I had a revision surgery to put the band back into its original place, 9 months later after subsequent fills didnt allow me to lose to weight I had gained from the band slipping, we converted from the lapband to gastric bypass. 

If you have any other questions, shoot me a message. Good Luck to you and just keep at it!!

how long did it take for you to finally be approved? i was suppose to have surgery on the 25th of january. i see my doctor tomorrow and im sure we will talk. i also had my preop tomorrow which of course i cant go because of the insurance. hopefully after talking with him tomorrow he can figure something out but im soo dissapointed im ready for this surgery and now it cant happen..

I too was denied just days before the original conversion surgery date. It took about 2 weeks to get the insurance paperwork squared away and approved. My surgery date I then picked because Im a fulltime student and it wouldnt have worked for me if I had done it ASAP, once approved they could have taken me that week for the surgery but I had to plan around school, so it was approximately a month after.  Just keep your head up and plugging away, itll happen.

Give Jennifer Johnson a call... I'm not sure why the surgeons in the Brigham/Faulkner group do this...  Jennifer is really good with knowing what would be approved or denied from the get-go.  If she thinks you'll be denied she's let you know what direction to go to appeal.

Jennifer Johnson
Bariatric Financial Coordinator
Program for Weight Loss Surgery
Phone: 617-732-6408

Good luck :-)
CJ