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

I stopped seeing mine a few years back after I had all the saline removed due to regurgatating in my sleep and aspirating during a surgery. At that point I was done with the band. I could have died.

Yep sounds like me too. 

I have a smallish update, the old doctor only submitted 8 of my 69 page medical records so we had to get the rest released and sent to the new doc becuause they need to be able to show compliance. I think they are finally submitting today (fingers crossed) but due to the delay and the doctors schedule, I am now having to push my surgery back to June 30th. I am hoping beyond hoping that we have enough for insurance to approve. Cigna did tell me it takes about 10 business days to hear back. So we shall see. 

Sounds like you are still on the right path. Good luck with that and glad you found out ahead of time the old doc didn't send all the paperwork yet.

Update from my side: APN felt there was a slip due to horizontal band, surgeon disagreed. However, band is still malfunctioning due to my GERD/loss of restriction symptoms, so they are still submitting to Cigna for a revision. At this point, because there is not a clear mechanical failure, I am expecting them to deny at the very least part of the surgery (probably revision to VSG) and ask me instead to submit for a brand new surgery. Brand new surgery would have a lot more requirements like psych eval, nutritional eval etc but in any case I already made those appointments and have been doing the 89 day weight management program with the APN. So it'll likely be a long road ahead for me. I'll let you know once I have submitted and also what they say. At this point, I'm just going through the required red tape so that if Cigna denies me point-blank the office will allow me to self pay. 

Are you still on liquids only now that the surgery has been pushed off?

Also, with self pay operations, does Cigna cover admission to a hospital due to any complications of it? So for example, life is going along fine but then a staple gets lose 3 years later, would they deny me because I didn't go through them for the surgery? I don't think so, but I wonder about that.

I dont know about the later part, but I imagine if its an emergency like that they would cover it. Im also self pay, and will be paying this off for the rest of my life haha. Im wondering why your doc sais a horizontal band is NOT a slip. A simple google search shows it is. 

and like you, just in case I need to do the new surgery route I too did the all the steps, just would need a june appt with my doc to make a 3 month eval. 

Yeah, not sure why he does not consider it a slip. I think it is because I don't have much swelling or stricture. My response to the reason why there is no swelling or stricture is because there is no fluid in the band...but I don't want to prove my point by having it filled and watching my pouch dilate again. I agree with you there.

Are you self paying for the revision but having Cigna pay for band removal? Which part are you self pay for?

I just got off the phone with the folks at the doc's office, and I feel a little bit more hopeful in terms of getting the surgery within a realistic time frame. Due to not being able to prove a direct mechanical failure, they'll likely deny a revision. They MAY pay for removal of the band, lets see. However, if they give me a denial, I can go through with the self-pay process, which is hopefully sooner than waiting on Cigna to deny me anyway due to lack of co-morbidities/not high enough BMI and no proven mechanical failure. They are going to submit my paperwork to Cigna by the end of the week. Any answer is better than being up in the air. 

so by self pay, I am self paying the hospital as cigna on my plan only covers 10000 and then I am also paying 2300 to my doctor. Hopefully that 10 Grand will help the hospital bill a bit. 

As far as liquids go, I have been keeping to them but having a healthy option for dinner. Except tonight, its a party for my mom so I will eat a bit more than normal but by doing the shakes as my main meal and having only 1 meal for dinner I have still lost weight. 

Please update us on the status of your approval. Waiting to see what they say, as it looks like you've done everything they asked.

Still awaiting... should know sometime next week.