is that a light I see?
As some of you have followed the saga of my journey I have come upon yet another fork in the road.
If you'll remember I was denied by my PCP, who think WLS is unncessary for anyone adn I just need to eat less and exercise more. I made him put in for WLS knowing he/they(medical group) was going to deny it. They did, and I freaked out and essentially gave up and figured I was boomed to a shorter misserible life. today I got the urge to ruffle some feather about this adn decided I would appeal the denial. Called the Medical group they suggested a 2nd Psyche eval and then even it was denied I could appeal directly through Blue Cross.
I called BC to verify and they said why go back to same medical group. Get the second opinion but let me fax you a list of other Drs you can go see. My plan does NOT require me to use the medical groups pyches or doctors. I am back at square one but at least there is still hope, again.
The issues is getting them to cover the VSG. which she is looking into for me and will call me late with info on whether its covered now or might be covered soon.
Things have certainly gotten better in the last couple of hours. Gotta call from the lady at BC they are NOW covering VSG in CA. Not a straight approval every single one has to be reviewed by a supervisor but it is at least on their radar.
I would still call to make sure but after two hours of "looking" this is what she found out
Always enjoy the preciseness and detail of your posts. My surgeon does VSG's, too (but prefers RNY's). Was thinking about what exactly the VSG is and what benefits it has over the RNY and Lap Band. My impression of the VSG procedure is:
1.They cut away and remove all but the side portion of the stomach, leaving an elongated pouch (sleeve)
2. The exit valve in the stomach is left in tact, which means, although you don't get full as fast, you stay full longer (correct?) Have I got this right?
Thanks, Dave
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