FRUSTRATED!!!
Okay so I'm in the process of getting prepared to submit to insurance for a revision. I have been working on this since November. I had a consult with my surgeon, who explained to me the risks, and the procedure for getting revised from Lap Band to RnY. He is going to do it in two separate surgeries (not for any particular reason, because all my tests have come back good, but just because that's how he does it). I have to get my band out first and wait 4 weeks to get the bypass. I'm fine with that. He informed me that I could get the band out whenever I wanted. Well I am a student, and the only time I have to get the RnY is Spring Break which is in Mid-March, so for the last 6 weeks I have been trying to get the Dr.'s Office to set me up for a removal but its like pulling teeth!!! I call, they don't call back. I make an impromptu visit and the insurance coordinator proceeds to explain to me all the reasons why she thinks I won't get approved for revision. Apparently she believes I have been non-compliant (even though I have stuck with my fill appointments, and the Dr. refuses to fill me any further). Last time I checked her job was to submit to insurance and find out what the insurance company says, not make the decision herself and try to scare patients away with her negative opinions. I realize I can be denied. Denials are common I think. But if I give up and don't even TRY to get approved, what have I been doing these last 3 months? I want to get this weight off, I want to be healthy. My health conditions make it harder for me to lose weight. The psych says I am a great candidate for revision and through this process thus far, multiple Dr.'s have stated in no uncertain terms that the Lap Band really doesn't work for most people (some people yes, but not everyone). Why would I just give up and not even ask the insurance company if they will approve it? Even if they do say no, I am going to appeal until I can't any more. And if I still can't get the surgery, I have another back-up plan. I am re-entering the job market in less than 1 year, and I will try again on another insurance plan.
All I want now is to get this band out. I don't need to wait for the insurance company to say yes or no on the revision. The band isn't working for me, I have no restriction, I can eat a lot and I get hungry frequently, so I can get the same results without the band. As of today I am only 8 pounds lighter than I was on the day of surgery. If I get the band out now, I will be ready to get the bypass done during Spring Break. And if I don't get approved, the new insurance company won't even know that I once had bariatric surgery in which case it would not be considered a revision, but a new surgery. My frustration is that the insurance coordinator informed me last week that she would submit to insurance (for the removal, not the revision), I have been calling all week to confirm this and finally someone called me back today after I got a little snide with the receptionist because the person I left messages for hadn't called back. They need to stop dragging their feet because if I get denied, I am going to use the time before I change insurances to select another surgeon.
Wow mama! That is ridiculous to be treated that way, especially by someone who knows nothing about you and has not dealt with you in any personal ways such as the nurses or surgeon in that office! I too am looking to get my revision over Spring Break bc thats when Im off from school as well. I really hope this turns around for you! You're in my thoughts ;) Take care!
Tonya
