My Revision Turned Down By Insurance Company!
The New York City Healthline has reviewed everything sent in by my doctor's office and have denied me for the revision from lapband to RNY... They insist that they never received six months of doctor supervised weightloss - not true, and also that it is not medically necessary - also not true. I guess I am back to the land of appeals! I also made an appointment with my gastro doctor because I cannot stand this reflux. The first appointment I could get was August 6th - almost a month from now!
I am so sorry to hear they denied you. This is just another stumbling block that they are giving you. Do not give up!!! Insurance companies are worse than the bad lawyers....but don't let them bring yo down. Fight until they give you what you need....the revision. Good luck.
Erica
"Nothing tastes as good as THIN feels"
"If at first you DO succeed- try not to look too amazed!"
"I am anointed. I can accomplish my dreams. I can overcome any obstacle. I am equipped and empowered by the Creator of the universe! I am able to live the abundant life God has in store!"
"If at first you DO succeed- try not to look too amazed!"
"I am anointed. I can accomplish my dreams. I can overcome any obstacle. I am equipped and empowered by the Creator of the universe! I am able to live the abundant life God has in store!"
You do know Marcia that many people get the RnY and it fails them? They go through reflux, etc and weight gain, etc. Are you sure you want to chance it with a RnY? Just want to know if you are aware, that's all? I had RnY 3 years ago and regret it immensely. Now I am on my way to a DS. Check us out. DS forum @ OH.
KAREN W.
I LOVE MY DS!!!!!
STRIVE TO BE THE BEST YOU CAN BE AND DO THE BEST THAT YOU CAN.
Check out www.dsfacts.com and www.duodenalswitch.com for all the accurate information on the great DS, and find surgeons in your area or around the country or out of the country.
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SW: 234.5 CW: 157 GW: 140 - ish
Marcia,
I am sorry to hear this. It IS medically necessary due to the fact your band is causing your GERD. My band was doing this to me.
I must say my initial request was denied then they approved me the following week. I hope you are able to get your gastro doc on board to help you fight the insurance company.
It sounds like your insurance company is trying every angle to get out of paying for a revision. I wish you much luck in your appeal.
Fight the good fight and don't let them win! You DESERVE and NEED a revision.
Valerie
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