Insurance Approval for Revision from Band to RNY

emjayel56
on 8/3/09 3:11 pm - Boynton Beach,, FL
Hello everyone... i got the best news today!!!!  I have had 2 lapbands over the past 10 years.. lost 100 lbs. but still have at least another 50-60 to go unable to do so beause of lap band problems. Well today was the best day...... I got insurance approval to do my revision and am hoping by month's end to revise to a gastric bypass.   Have a great day.
Can't Weight TooLose
on 8/3/09 11:08 pm
Wow! That's great. What ins do you have and did they have alot if requirements for the revision since you have only 50-60lbs left to loose?
Highest weight- 262lbs
Lap band- Aug 2006 - 254lbs.
Lowest w/band 214lbs. .
Gained up to 271 due to the band
Got DS revision April 2010!! Current 145lbs
At 5'8 my goal was 160lbs but I surpassed that with the DS!!!!!!



brandyII
on 8/4/09 8:08 am
Congrats on your approval hope things work out for you now, Nancy.
      Revised from Lap band 8/22/07 to RNY 6/11/09   Starting weight 259lbs
      
emjayel56
on 8/4/09 9:47 am - Boynton Beach,, FL
Thanks for your good wishes; i have United Healthcare (NY Empire).  Should have a date for surgery this week.   Good luck to you as well.
angibug
on 8/5/09 5:40 am - Las Vegas, NV
Congrats! So happy for you! I am playing the waiting game...it has been 13 days so far...
emjayel56
on 8/5/09 5:49 am - Boynton Beach,, FL
Good luck; waiting is the worst!
asweeten
on 8/5/09 2:28 pm
That is awsome news.  I had bad news today.  My insurance denied my revision from non-adjustable band to bypass.  I went Monday and had UGI series and it shows I have an obstruction and erosion which explains the severe reflux I have.  I thought that would be good news as we proved medical necessity but my insurance doesn't cover bypass for any reason.  So...tomorrow I am on the phone fighting with my payroll services which provides my insurance and with BCBS of Texas.  The sad thing is I have been with this same payroll service and kept their insurance for 10 years.  I had the band 10 years ago and our insurance paid for it.  It just doesn't make sense.  I don't want to take the band off since I am still at a good weight but I also can't keep living like this.  I guess I will leave it up to the doctor as to whether I should keep the band or remove it without revision and gain the weight back.  If anyone has any advise I would appreciate it.
emjayel56
on 8/5/09 9:36 pm - Boynton Beach,, FL
Wow that sure is upsetting news.  Well why don't you put in for a replacement of the band.  If it is eroded it has to come up and they should easily approve a replacement.  Otherwise, maybe you have to appeal it.  Hang in there and keep me posted.  Maryjo
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