revision from lap-band to VSG BCBS approval concerns

Has anyone had their lap-band taken out and revised to another surgery VSG, RNY etc? I was told today by BCBS that although I have a surgery date to remove the lap-band I will need to go through psych eval., weight management for several months before they will appove the VSG. They literally want me to go through two surgeries one on July 10 to remove the band and then after the psych eval., weight management etc I can get approved for the other...instead of getting them both done at the same time!

Hi,

It depends on why the band is being removed. My revision was approved from band to sleeve (one step). My predetermination for the revision was based on me having a band slip, pseudo achalasia of the esophagus and dysphagia. The revision was based on my inability to have another band and that I was not a candidate for a RNY. Prior to banding complications, I had lost 155 pounds. DId someone tell you this on the phone or did this come to you in writing. Usually for a revision if it is due to a complication, they dont require you start the process again. Is it possible that they misunderstood you about your desire to have this done in one procedure.?

Babs

Hi my name is Debbie, I live in East Boston. Soon I will undergo the RNY. I am already approved and all. My question is related to my sister... She will hace the LapBand..She had Harvard Pilgrim health insurance, today she found out that as of August 1st, she will have TUFTS and she called them to find out the requirements are and she would most likely have to do the 6 month NUT visits or it could be overriden by the Dr./Surgeon so that she doesn't have to wait and do the visits. Have you ever heard of this? What were your requirements? I see that you also have TUFTS. Any help will be appreciated...Debbie

The insurance I have (Tufts) is also permitting my band to be removed and RNY on the same day. I did need to have an upper GI...although it didn't show the leak (duh...) and i had to have a re-visit update with the Nut. They did want a special letter from the Doc after the initial paperwork submission. Joan

Thanks for your responses; I got this info from the Doc's secretary...I really need to speak with the Dr and get his take on it.  I think the secretary got a phone call from  the insurance company this morning.

Hi, read the criteria for revision and go by that.  People often are not knowledgable about insurance.  It is best to read it for yourself and then call your insurance company.   You may need to have another psy eval as this is another surgery.  The insurance company wants to make sure you are able to handle the changes and work with the information provided for your surgery pre and post op. All the best, Cynthia

It depends on your employer. They decide the level of insurance and the requirements. I have BCBS FEDERAL and am getting a revision from lap band to RNY and I was not required to do anything preop. No diet history, no nutritionist, no psych. All I had to have was a BMI over 35 with comorbidities. My doctor is taking out my band  and revising to the RNY in one surgery.