band removal

what is their reason for denying the revision  Ask for  a appeal and ask for a peer to peer review in which they talk to the surgeon. 


my insurance paid for the bypass but did not pay for the removal of the band.  My dr and hospital ate the charge for the removal of the band

We have appealed it 2 or 3 times and also had a peer to peer review. It was denied on the policy phrases of " 1 bariatric surgery per lifetime".  This last time the insurance company even called me when they received it and basically told me to knock it off and to quit trying cause they wouldn't cover it.
Steph

lap band removal is a relatively simple surgery, i went home within a few hours after removal.  recovery is easy, depending on what you do for work, health status you should be back to work in days or weeks.  since you have a 1 time surgery clause in your insurance, no amount of appeals will work....try to change insurance policies if you can or self pay.....wishing you luck with your choice

I had the band out as an outpatient procedure. Piece of cake! I didn't need any pain meds and was shopping the next day and at grocery store that evening after surgery.

My removal was approved and revision has been denied twice due to my co-morbids not life threatening enough! So i would have to gain more weight to have it approved. Unethical yes! But a lot of insurance co. do it. Bs! I too have a sel-funded policy. I think those are harder appeals to overturn.
I am self pay now with dr. Kelly in Mexico. This is actually a blessing since he has much more experience than my surgeon here.

I have always been self pay.  Had my band out in July and had to wait until October to get the sleeve due to scar tissue.  Having the band out was a piece of cake - up the same day and shopping the next.

Good luck with your appeals.

Donna

i hope it all goes well...good luck to you. Keep trying to get the revision...It took me 3 years to finally get my removal...and at that point I didn't want a revision...just band removal...but with my barretts esophagus my doctor wanted the RNY done. Ask if they will cover a revision if it is medically necessary due to issues resulting from the lap band like...hiatal hernia, pyloric valve disfunction or severe gastritis...and so on.

I just had a revision from the lap band to the RNY. I have triwest healt care coverage..and it was done on the naval base in San Diego.
I felt like a truck ran me over after the surgery...but i am feeling so much better now. I had a hiatal hernia repaired also, along with the band removal and RNY revision.   I had my band for 7 years...the last 3 of it, giving me Barretts Esophagus...with the possiblity of cancer of the Esophagus.
I was in the hospital for 3 days...for all this...wednesday surgery, friday dismissal...I feel better every day.

We tried from every angle including the medical aspect of it because I have esophageal dilation already. They basically told us that that is to bad. They will pay for removal and that is all.  So from an insurance aspect, I am basically screwed. Since I work for a different hospital than the one my surgeon works at, we are looking to see if the two facilities can do some "in kind" type of trade. I guess it pays to be a loyal long-term employee after all. Nothing is set yet, but talks should be starting soon. Thankfully the eating side of things is getting better and I'm able to keep down a lot of solids. Still having trouble with the heavy meats like chicken, but as long as I take my time and focus on nothing else, then they go down.

Steph