Just found out Im approved

dinty4
on 9/24/08 2:59 am
After a few weeks of waiting anxiously for word from doc office or ins co...I finally found out today that I have been apporved for my revision surgery.   after the doctor's office gets the written approval paperwork, I will then have to go get my pre-op labs done, then set a date...woohooo.  
KIMMAD
on 9/24/08 3:35 am - IN
Congratulations!!!  What wonderful news!  Can I ask which revision you will be having? 
dinty4
on 9/24/08 3:51 am
On September 24, 2008 at 10:35 AM Pacific Time, KIMMAD wrote:
Congratulations!!!  What wonderful news!  Can I ask which revision you will be having? 
Thanks, I dont know the name of it, but I originally had the RNY back in 2001.  So a few weeks ago I had an upper GI to see how the puch looked, and it was stretched. So she will be trimming the pouch back down to it's proper size.
KIMMAD
on 9/24/08 7:06 am - IN
I am in a similar situation so forgive me if I ask too many questions!  I also had a rny in Feb 2002 , lost about 150 lbs, and have since gained all but about 50 pounds back.  I am scheduled to see Dr. Inman on Monday for a consultation.  (she is not my original surgeon)  I'm really anxious to see her to talk about the possibilities.  I've heard of so many people revising to a DS, VSG, or band over the pouch, but I guess I wasn't aware that the surgeon could just go in and make the pouch smaller again!  It sure seems a whole lot simpler than going thru the other procedures.  My main concern is whether my insurance will cover ANY revision.  To make a long story short, my husband switched jobs and our insurance has changed.  Our new insurance carrier specifically says that any procedures due to obesity are NOT covered.  HOWEVER, there may be a possibility of appealing if there is "Medical Necessity" and the the underlying diagnosis/treatment is not due to obesity but is to another condition such as  high blood  pressure, etc.  So...... it looks like it's going to be a long road ahead of me!     

Did you have a difficult time getting your insurance to pay for your revision?  Did they deem it medically necessary?  Did the surgeon tell you about how long you would be "out of commission"?  Are the results of a revised rny similar to that of the original procedure?

Sorry to ask so many questions, just very curious    !!  Again, congrats to you!  You'll soon be on your way again!!   
dinty4
on 9/24/08 9:32 pm
On September 24, 2008 at 2:06 PM Pacific Time, KIMMAD wrote:
I am in a similar situation so forgive me if I ask too many questions!  I also had a rny in Feb 2002 , lost about 150 lbs, and have since gained all but about 50 pounds back.  I am scheduled to see Dr. Inman on Monday for a consultation.  (she is not my original surgeon)  I'm really anxious to see her to talk about the possibilities.  I've heard of so many people revising to a DS, VSG, or band over the pouch, but I guess I wasn't aware that the surgeon could just go in and make the pouch smaller again!  It sure seems a whole lot simpler than going thru the other procedures.  My main concern is whether my insurance will cover ANY revision.  To make a long story short, my husband switched jobs and our insurance has changed.  Our new insurance carrier specifically says that any procedures due to obesity are NOT covered.  HOWEVER, there may be a possibility of appealing if there is "Medical Necessity" and the the underlying diagnosis/treatment is not due to obesity but is to another condition such as  high blood  pressure, etc.  So...... it looks like it's going to be a long road ahead of me!     

Did you have a difficult time getting your insurance to pay for your revision?  Did they deem it medically necessary?  Did the surgeon tell you about how long you would be "out of commission"?  Are the results of a revised rny similar to that of the original procedure?

Sorry to ask so many questions, just very curious    !!  Again, congrats to you!  You'll soon be on your way again!!   

thanks, and you didnt ask much.  I have United Healthcare, and my BMI is high enough to qualify for WLS, so no I didnt have a problem getting them to cover it.  They are going to try Lapro, but since I had an open back in 2001, they may have to go in open.  If I go open, I should be out for about 4-5 weeks, Lapro would be about 3 weeks.  She also told me that the results wont be as dramatic, but I should still see about a 100 weight loss..good luck with your ins co.  

mew6495
on 9/24/08 10:51 am - MI
 CONGRATULATIONS on your approval!  How wonderful!  I wish you much luck and hope your revision is everything you want it to be.  I also had RNY in 2001 and my revision is scheduled for Oct. 3rd.  I am going with the ERNY.  This is where they make your common channel shorter.  It reconstructs your intestines much like the DSers get but leaves the pouch alone.  Good luck and I look forward to your post that says "I GOT A DATE!".  
MARCIAM
on 9/25/08 9:14 am - Sayville, NY
Congratulations & good luck to you!
Marcia 297/169 so far/140
RNY on 9/22/08
My life is starting over & yours can too!
 





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