Revision Lap Band to DS - HELP!
I've been trying for over a year to get a revision fr lapband to DS. The first go around BCBS of IL refused a revision because they said I did not have a PHYSICAL MALFUNCTION of the band like slippage or erosion. Then my surgeon moved so I'm starting the process all over again with Dr. Rabkin (going to a seminar tonight).
Before I submit to the insurance company again, can any of you who have BCBS tell me how you got your revision to DS covered?
I have horrid heart burn, food gets stuck all the time (sometimes even liquid), but then if I drink soda before a meal I can get the food down. So either I'm stuck with heartburn, pain and throwing up or I'm wide open after drinking soda which I"m sure is stretching my band.
I can feel food squeezing through the banded part of my stomach and it is horrid. I have pain, nausea, vomiting and I've taken to sticking my finger down my throat just to get rid of the food after I eat (no I'm not bulemic). Even smooth food chewed tiny sometimes gets stuck! It is so FRUSTRATING !!!
I just don't know what the insurance company wants! I had lap band surgery in 2007 - lost 80 pounds gained it all back. I am so MISERABLE !
Any one who can give me pointers and share your story I would be VERY grateful. I'm wondering if I should have band removed in one surgery then come back for DS ??? Would insurance even pay to remove it? I HATE MY BAND !!!
Thank you Thank you Thank you. I am so grateful for obesity help.com
Cindy
Before I submit to the insurance company again, can any of you who have BCBS tell me how you got your revision to DS covered?
I have horrid heart burn, food gets stuck all the time (sometimes even liquid), but then if I drink soda before a meal I can get the food down. So either I'm stuck with heartburn, pain and throwing up or I'm wide open after drinking soda which I"m sure is stretching my band.
I can feel food squeezing through the banded part of my stomach and it is horrid. I have pain, nausea, vomiting and I've taken to sticking my finger down my throat just to get rid of the food after I eat (no I'm not bulemic). Even smooth food chewed tiny sometimes gets stuck! It is so FRUSTRATING !!!
I just don't know what the insurance company wants! I had lap band surgery in 2007 - lost 80 pounds gained it all back. I am so MISERABLE !
Any one who can give me pointers and share your story I would be VERY grateful. I'm wondering if I should have band removed in one surgery then come back for DS ??? Would insurance even pay to remove it? I HATE MY BAND !!!
Thank you Thank you Thank you. I am so grateful for obesity help.com
Cindy
Grandma Cindy
326/286/140 (start/current/goal)
(deactivated member)
on 11/15/10 4:51 am
on 11/15/10 4:51 am
hi Cindy,
Sorry for all the issues you are having. all insurance policies are different, but according to your post above unless you have a physical malfunction your revision is not deemed medically necessary. I have BCBS and that was the case for me also, unfortunetly I did have many issues including physical malfunctions that caused irreversible damage. One question is are you sure you don't have any issues? Have you had a recent barium swallow, if not ask for one, and for insurance to revise you, they want proof, yep, fluoros etc. You really shouldnt drink soda, the carbonation is really not good for the band/esophogus. From your symptoms you are way over restricted, have it partially deflated, as you have now developed a maladaptive eating disorder, classic over restriction symptoms. I had to have my band removed and heal for a while before anyone would even think of touching me, but it was medically necessary as slippage and erosion can be life threatening, yes I had those amongst other things. Wishing you well.
Mila
Sorry for all the issues you are having. all insurance policies are different, but according to your post above unless you have a physical malfunction your revision is not deemed medically necessary. I have BCBS and that was the case for me also, unfortunetly I did have many issues including physical malfunctions that caused irreversible damage. One question is are you sure you don't have any issues? Have you had a recent barium swallow, if not ask for one, and for insurance to revise you, they want proof, yep, fluoros etc. You really shouldnt drink soda, the carbonation is really not good for the band/esophogus. From your symptoms you are way over restricted, have it partially deflated, as you have now developed a maladaptive eating disorder, classic over restriction symptoms. I had to have my band removed and heal for a while before anyone would even think of touching me, but it was medically necessary as slippage and erosion can be life threatening, yes I had those amongst other things. Wishing you well.
Mila
Hi, I am in the same boat as you, but my revision from band to RNY is scheduled for Dec. 6...
I have medicare...Have all the same problems you stated...Had the swallow test.. took 2 swallows and nothing was going down, had the scope ran down my throat, couldn't finish the test because of problems... A revision for medicare has to be medically necessary...Sounds like you need thesse test and maybe that will help with Insurance coverage...
I have medicare...Have all the same problems you stated...Had the swallow test.. took 2 swallows and nothing was going down, had the scope ran down my throat, couldn't finish the test because of problems... A revision for medicare has to be medically necessary...Sounds like you need thesse test and maybe that will help with Insurance coverage...
Most Active
Recent Topics
