REVISION....BCBS/GHI......Just Wondering....

My surgeon has informed me that I need to go through a six month weight loss program and have another psychological evaluation before a request is made to my insurance company.  Has anyone gone through all of this and was still denied by BCBS/GHI?  If so, did you eventually get approved for the revision surgery?

Thanks!

Y.

Hi\
I am going thru the 6 month supervised diet. i have bcbs/ghi
Who is your surgeon? I have Dr. Inabnet. What kind of revision are you having?

Hi,

The Lap Band was one option my doctor discussed with me.  I'll start the six month supervised diet in December, but I would hate to spend all that money on the six month program and the psych eval and then I get denied by my insurance.  When did you start your six month program?  Which revision are you going to have?  My doctor's name is Dr. Texiera. 

Thanks for responding!

Y.

HI
I started the diet in August, i am having the RNY to DS revision, my doctor says the lapband would not help, he feels it is a waste of time.

Dana

Hello Dana,

How is the diet going for you?  I notice in a lot of the post that people are going from RNY to DS.  Like I said one of the options the doctor discussed with me was the lap band, but I'm going to talk to him about the DS.  I too had the RNY, but I'm gaining weight and never really lost the amount of weight my original surgeon told me I would possibly lose. 

Y.

My Pcp put me on diet pills, not losing any weight. Not all doctors can do the DS. Call Dr. Inabnet in Mt. Sinai,he does  these revisions.

OMG I'm sorry you're not losing weight I hope the pills help!  I will definitely look into Dr. Inabnet.

Thanks!

Y.

Yes, I have BCBS of Illinois, I was denied 3 times over the course of 1.5 yrs, and finally got approved for my revision.  I had the surgery Dec. 3.  My problems where that it took so long to get all the dr. notes from original surgeron since it was so long between surgeries, and he purges his notes every 5 years.  I finally found them at a different hospital that I forgot that I had sent a request for them.  Within a week of getting these notes to insurance I was approved.  Keep working at it, and make sure you have previous dr. notes, that was the hardest part.  

WOW!  3 times!  My new surgeon is in the office where my old surgeon was when I had the surgery so all of his (old surgeon) notes are in my file.  Which surgery did you have originally?  Which revision surgery did you have?  It sounds like having the notes was all BCBS needed to approve you?  I truly dread going through that long process to get approved, but  I'm gaining weight and it's driving me crazy!!!! I just can't give up!
 
Thanks for responding!

Y.

I was approved for RNY to DS on the first try. Did the psych & nutritional evaluations, and I did the 6 month diet for 5 months with my pcp.  I also submitted proof that I had esophageal erosion.  I had Horizon BCBS NJ.