Revision band to RNY... worried about denial (cigna and slippage)

So I am trying to get my band revised to RNY, upper GI shows band is Horizontal, not sure if that counts as slipped or not? But the doc is trying to get authorization without the 3/6 month required supervised wl plan. Im worried Cigna will deny for this as Im not sure if its a true sli*****t. They have me on my pre op diet already (planned sugery date is 6/2) and of course Im a bit moody and emotional from not eating solids and the worry for denial. Im kind of feeling lost and can't get the worry out. Any advice? anyone have this sucsesfully with Cigna? 

I didn't have Cigna, but I just had my band removed and I was revised to Bypass. I wanted to wish you luck with your journey though, it's a bit of a roller coaster but stick with it and you'll get there!

Thanks for the fast reply, I really really need and want this. 

I just want to wish you well and anyone who can get rid of a band is very lucky indeed!!

Right! My Sil had hers emergency taken out it got so bad.

Unless it is an emergency band removal Cigna will require 3 months of supervised diet/exercise for the revision.  I am dealing with them now.  I have one more appointment with the nutrionist and hopefully in the next month or two I can get the band to bypass done.  Cigna did already approve to have my band out, but I want to do both at the same time. 

You very well could get the approval for the band removal, but they are still going to require you to go through all the steps for the bypass. 

Was your band slipped?

No slip, but I have constant heartburn 24/7 and nothing seems to help it.  My band was emptied a few years ago also, but I always went every 6 months to see my doctor.

Hi there,

I am in the same position as you, in terms of having a suspected slipped band (Nurse Practitioner reviewed GI but surgeon needs to sign off on it). My Band is horizontal instead of pointing towards the heart as it should be. I am unsure whether or not I have pouch dilation, but even if I don't have it now...with a slipped band you will eventually develop it. I read somewhere as well that typically the band itself isn't always the thing that slips....rather the stomach slips through the band or changes position. Not totally sure on that, though. I had a slipped band last year that obstructed my stomach, I couldn't even swallow water or my own spit. I was admitted into the hospital, but foolishly chose to simply have the band repositioned because I had done well with it beforehand. 

In any case, wanted to offer my support and let you know you are NOT alone. I have Cigna as well...and they've been anything but straightforward with me for some reason. I agree with the other folks in that, most likely, since you are having a new surgery Cigna will require you to go through the 3 or 6 month supervised weight loss plan. The best advice I can give you is to preemptively tackle all of the requirements, even if you think it may not be necessary. Print out the WLS coverage sheet Cigna has available on their website...if you cannot find it, call them and request it to be emailed to you.

After that, sit down with the folks at your doctor's/surgeon's office and make a game plan with them as to what exactly you will need to do for the insurance and for the surgeon in order to get the show on the road. After that, make all of your appointments. You can always cancel the appointments if Cigna approves you without needing the supervised stuff. Aggressively call the insurance and your doctor's office as each appointment gets done so that your checklist is updated. You absolutely must take agency with your authorization request. 

Question for you: Have you talked with Cigna at all about this? Any info regarding what exactly is needed to prove a "medical necessity".

Hoping for a speedy resolution!