Need help. Dr Jayaseelan in Dallas and band to sleeve revision with bmi of 33

Hi All. Im new here and this is my first post but Im needing to see if anyone else has had these problems with approval. I have had a failed lap band since 2004. I have never lost more than 20lbs with it and the past year it has really started to hurt like a pulled muscle. FINALLY went to the same doctor who did the original band. He agreed that I should revise to the sleeve. Im 5'8" and weigh 224 but, I already have high blood pressure, high cholesterol, diabetic and a whole host of other problems. All of these require that I take 7 different medications a day. The insurance handler at Dr. Jays office informed me that #1 Cigna never approves anyone for revision with a bmi of less than 35. #2 She is very busy and wont even be able to send the precert in til the end of next week. #3 They will deny me anyway. And Ive had no follow up the past several years so I would need nutritional counseling and "follow up" before anything would be approved. Maybe Im missing something here but I thought she was supposed to be an advocate for me not for the insurance company. Ive had this miserable band in for almost 10 years and I weigh within 10lbs of what I did when it went in. Very frustrating...has anyone else had experience or success with any of these issues? I was really wanting to revise before the end of the year because of my deductible being met. 

ok so here is some tough love....the dr's office is not your advocate, you are your advocate...what does your subscriber agreement say? what is the sections on covered benefits, what about the exclusions?   if you have no idea, well then you are a lamb going into slaughter.  and why would you want to trust someone with that?   do you think a dr's office knows all the insurance plans out there?  every employer picks what they want to cover, no drs office can possibly know, they are guessing unless they have YOUR subscriber agreement.  the 35 bmi is typical and comes from the NIH...you are only 7 lbs away from that....geesh get weighed in the evening after dinner at the drs office and drink a lot of water, we all fluctuant in weight .  What you do need is for them to submit, but better wait till you get weighed again, you are soo close, after you get a 35+ bmi, hound them till they submit, then when you receive your denial follow your explicit directions on how to appeal in your subscriber agreement..and for heavens sake don't have the dr's office appeal for you....good luck

 US National Institues of Health recommends bariatric surgery for obese people with a body mass index (BMI) of at least 40, and for people with BMI 35 and serious coexisting medical conditions such as diabetes.

Who weighs you for the "official" BMI.  My pcp had to weigh me and submit the info to the insurance co with my co-morbs.  My PCP weigh with shoes and cloths on.  When they weighed me at the center I had to ditch the shoes.  I weighed in with my heaviest shoes on and winter cloths.  My bmi was 35.2 there at the surgery center it was only 32 and I wouldn't have made it.