Denied Revision

Hi,

I was denied also needed a revision from VBG to RNY.  Please consider hiring Lindstrom Advocacy to fight the fight for you.  I was denied three times then went outside to peer review and the insurance companies denial was overturned.  It was because I hired Lindstrom after the first denial that I was able to have my revision done on 8/6/13!  You have a better chance of winning with Lindstrom if you hire them sooner because they know how to position your case for outside peer review.  Good luck to you and never give up! 

eClicker- I will look into that, thank you. 

" There is no perioperative or late complication of previous bariatric surgery. There are no complications such as staple-line failure, obstruction, stricture, non-absorption resulting in hypoglycemia or malnutrition, weight loss of 20% or more below ideal body weight."" 

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That guideline does not even apply to a band; it applies to stomach stapling procedures.  Your severe reflux, and failure to lose weight, are the symptoms of a failed band surgery.  Don't give up.   Have your surgeon write an appeal letter explaining the problems with your lap band, and his recommendation for addressing them.  Even if you had no other surgery for the purposes of weight loss, you would still need surgery to remove the band which is endangering your health, so either way, you'd need surgery.  I hope you get your approval.

I agree. Most of this week has been spent trying to get in contact with my surgeons office to see what they were going to do about the appeal. No returned calls yet so I am hoping to hear something this week. If I have not heard back from them I plan to appeal on my own. I will definitely keep everyone posted.