Approved after Peer to Peer

The first time I remember having reflux was in 2005. I have had it FOREVER. That was FOUR YEARS (and at least 20 pounds) before my sleeve. My surgeon said they no longer recommend the sleeve for anyone who has preexisting GERD. But I know there are a lot of people who do fine with it as the ensuing weight loss cures the GERD. Unfortunately, no one can say if you'll be in that group. Good luck!!!

I was denied. So now we are to the peer-to-peer stage which can't be done until mid-July because of scheduling difficulties. More waiting! 

They said it was not a covered benefit due to coding, but it was coded as weight loss surgery and not as hiatal hernia surgery. So who knows??? The whole thing makes me crazy!

I woke up again last night aspirating acid into my lungs. Guess they would prefer I die than cover the surgery I so desperately need!

Hi you mentioned the initial request was denied due to location.  Do you have UHC Optum?  I am in the process of getting a revision band to RNY but my case nurse told me I will get denied due to location. The nearest hospital or doctor is and hour away from me.  I also have an issue of seeing another doctor because I'm so comfortable with the one I have.  I was just wondering what you did to have them change their mind about the location or is it because your doctor works out of one they approve of.  I sent a letter in with my file pretty much begging them to let my doctor and the hospital I know and love do my surgery so I guess only time will tell.  I hope not too much time because I have a date of July 17th!! My doctor even made a special date for me because of scheduling issues I will have.  If anyone else has any info on this please let me know.  At this point my reflux is horrible I'm sick on a daily basis and I don't know if I could sit for another doctor.

Sorry for the delayed response. My internet went out and this forum doesn't pull up well on my phone.
My surgeons office selected their surgical center, my insurance does not work with  surgical center , my surgery will be at my actual hospital where my pcp is located. so they just resubmitted the paper work with my hospital that has some center of excellence designation. I do have uhc and I logged on to their site and viewed the hospitals in the area, luckily my hospital was there.