Just had my revision this week!

Wanted SOMEone to know- I finally got my old (4.5 yrs) VBG revised to a RNY this past Monday (March 24th). The doctor was able to accomplish that AND a surprise hiatal hernia repair thru scope surgery afterall- no open incision to take for ever to heal! It took over 8 months of bickering with my insurance company (UHC) and 6 of those months were my own efforts working with my husband's union to convience UHC that I did, indeed, qualify for the revision. So wish me luck and if ANYone has any advise or tips (u know, the RNY is vastly different than the VBG- I am having to relearn every thing!) PLEASE message them to me! Kisses and thank you all for your contributions and support! Tamera Dallas [email protected]

Congratulations!  I am so glad to hear that you WON!  I am in the same battle right now with UHC, working on my second appeal.   I would love to hear what finally worked for you.   I wish you all the best with your new RNY and I know that you will do great!  Keep us posted! Teri

After the 2nd turn down from UHC they said their hands were tied and I had to appeal directly to the HR administrators with my husband's company. OMG! So I copied EVERYTHING I had previously sent to UHC (PCP visit notes with weights and bloodpressures- & meds- highlighted, upper GI report showing the staple line break down, letter of medical necessity from my new surgeon) plus the letters to UHC sighting the success I had when the VBG was working and how my B/P went in the toilet just about the time it gave out and the weight slowly began to creep up, told them about all the exercise I get, the gyms I belong to, the pilates classes I take, bought a bike- u name it-- I showed that I followed my surgeon's plan and made real life style changes. And in the final appeal letter I quoted the policy stating "40% BMI OR a 35% BMI WITH a co-morbidity" and gave my statistics which barely reflected the qualifying BMI (that, again, was all documented on my monthly PCP check ups to adjust the blood pressure meds). I was at the end of my ideas and resources when I got the approval. (For 2 years I worked with my former surgeon- I was employed by the hospital as the RN who coordinated the program on the hospital side of things so I SORTA dealt with patients who had been declined or told they needed 6 months of physician-supervised diets, etc-- but I never paid attention to the details of the office staff writting appeals cos it all sounded so horrid! Now I wish I HAD paid attention!)  Keep trying. I'll say a little prayer! Tamera

WOW.  You have really been thru the wringer!  It never ceases to amaze me how blind the insurance companies can be ... guess that happens when the only color you can see is green.  But HELLO.....  Well, I am really glad to hear that you finally won.  It will all be worth it in no time.   UHC has told me that my companies policy (Continental Airlines) states that you can only have 1 bariatric surgery per lifetime and are denying me on that basis.  I am trying to fight it becuase the policy states 1 per lifetime OR a BMI over 40, etc.  the key being the 'or' in the statement.  And although I had a VGB 14 years ago, my BMI is now over 40.  Hindsight, etc. etc...... I think you will do great with the revision - you have certainly worked hard enuf for it - and that will give you extra motivation.  I will say a little prayer for you too!! Teri

Huum- didn't American aquire Continental right before the September 11 incident? Seems I remember my Hunny saying they aquired SOME airline starting with a "C" ( I'm blonde and these things DO confuse me) and thats why they were so financially unstable when it all happened and had to lay off workers (not that the huge bonuses for the Execs COULDA been a contributing factor...).  Any way- if so, you should be covered by the same union- AFL-CIO.. and they stepped in and made the decision. It may just take getting the information to the right people. Email me and I can look thru paperwork for whom ever it was that I submitted the paper work. Tamera [email protected]

So happy to hear you have got a revision. I hope you are doing well. And will have very good success.  I hope to someday revise from VBG to RNY. Karen

Thank you, Hunny! I hope you get your revision, as well. Why insurance companies don't see the long term benefits, I just don't know. I realize it is a hefty expense but so is chronic illness, absenteeism and the emotional and social toll. A healthy person doesn't drain the insurance benefits like an unhealthy person- do the math! Keep us up to date on your progress toward revision, ok? Tamera =)