Having problems getting approved
I am having problems getting approved by Highmark Blue Shield for my revision. I have gained back 80 lbs., have a stretched stoma and a stretched pouch. Plus some of my co-morbidities are returning. Can't believe they shelled out almost $13,000 in all the pre-testing they required and then denied me. Going through the appeal process as I write this. I am totally frustrated!
In the last year, BCBS of NorthDakota has paid for 3 ER visits, 2 EGDs, CT scan, and an upper GI to find out that I have a esophageal dilation due to my realize band and they won't pay for a revision either. I asked if they would rather keep paying for ER visits and co-morbidities and they refused to answer me. Best of luck.
I have also been denied - twice!. My lapband sugeon wanted me to have GS but I wanted the gastric bypass so I switched doctors. I had what I think was a slipped band so new doc. took out all the fluid so now I have NO restriction and am slowly gaining. I have submitted letters from about every doc I have but to no avail. I have been told by a gastric bypass group to try once more then contact the state insurance board. In the meantime my comorbidities are increasing daily. UGH!!!!!
Gues we just have to keep trying.
Gues we just have to keep trying.
Take Care and God Bless
Maggie
Maggie
I can realte to the frustration. I have an RNY, and started my journey in March of '09.
So, here I am, 2 1/2 years later.... still dealing with the insurance. I will have my hearing (to hopefully overturn my denial of my appeal) in 3 weeks.
I wish you luck!!!!! KEEP FIGHTING!!!!!
-Jamie in Alaska
RNY 2/26/2002 DS 12/29/2011
HW 317 SW 263 BMI 45.1
SW 298 CW 192 BMI 32.9~60% EWL
LW 151 in 2003
TT 4/9/2003
Normal BMI 24.8 is my GOAL!!!
GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**
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