RNY to VSG denied by insurance

But the call from my surgeon's office said to hang in there because my surgeon is already arranging a conference call with the medical review board, since he does consider this surgery very medically necessary for me.  No guarantees, but they are 'cautiously optimistic.'

I'll be swinging my critters for you! You've had SUCH a hard way to go with this. Did you decide against the full DS, or do you just think it'll be easier to get approved for the Sleeve?

Best wishes I know you've been at this a long time. Yu are fortunate to have a very proactive surgeon!

My insurance also denied the approval twice for a revision .I'm also gonna have a medical review board review the case .I will also get a second opinion from the Davis Clinic in Houston. 

My prayers are for you to get approved! I know how important this is to you since I have been in your shoes with reactive hypoglycemia...I had no trouble with BCBS but I also had a hernia to repair...GOOD LUCK!

I have a hernia that needs repairing too!  I don't know if this insurance company will go for it.

I'm rooting for you. 

I know you've been here a long time, so I'm sure I'm not gonna say anything you don't already know, but I would actually locate, print out, and highlight relevant information in studies and make sure they were part of any appeal.

Like, if you have reactive hypoglycemia, find any studies you can about rh and it's prevalence with RNY or restoring the pylorus, for instance. I have learned to not trust my doctors or surgeon to do what seems obvious to me. I assume anything that the insurance doesn't feel in in their interest, I'm going to have to fight for it. I sound jaded, lol?

I hope you get your revision, and can feel better.

I had band erosion and slippage and requested removal of band and revision to RNY. My insurance (BCBS) approved the removal of the band but would only allow for the band to be replaced which seems ridiculous since it didn't work out. I enlisted the aid of an obesity advocacy group and for a small fee (only a fraction of what self pay for surgery would cost) they handled my appeal and I was approved for the bypass surgery. Don't take no for an answer and don't give up.

Ashley, since you've not had your RNY yet, take a warning from Linda S's situation and really re-think bypassing your pylorus. Have you seriously researched the Sleeve and the DS? Since they preserve the pylorus, rarely do post-ops develop RH. (And the DS has the very best long-term, maintained weight-loss stats.)

I have looked very closely at all three surgeries. I think when it all boils down the RNY is the best for me. I am going to read more about the DS because the surgeon I am using offers that as an option but at this point RNY seems like the best option. Thank you for the words of caution. I am going to read more forums about all surgeries. I am also concerned that DS cannot be reversed. I have read of cases where a patient develops severe issues later in life because of the vitamin and protein deficiency and the doctor ends up having to reverse RNY. I wonder what would happen if you have the DS. You are correct, it requires serious research. If I had done more research I would have never had the Lap Band, instead I would have had RNY.