appeal help

So a few weeks ago I got a denial letter for a revision from RNY to distal RNY. 
Since then I have upped my workouts to the point the remainding knee I have that is not a robot is headed the way of one... I have tried to live off of protien drinks exclusively and even then limited my calories to about 1000-1200 a day. And I have GAINED weight!  

Last week my 3 year old grandson was standing on my scale, I am exacatly 201 lbs more than him in weight.. now I should be at least a hundred, he is three...but 201!!! NOT.. Then two days ago in the gym, after swimming with my 6 year old granddaughter, she, pulled one pant leg of my jeans over her head and down to her hips before she had to stop! Yesterday, I went through a whole bunch of summer clothes that my daughter had shrunk out of after WLS herself. I was pulling out 2 & 3X shirts.. 12 years ago I had RNY- two years later I was wearing a size 6.. Now I am taking old clothes from my daughter who was at least as big as I was before surgery.. I NEVER  though I would do that again!!! Wear a 2/3X ... 

After thinking for a few weeks/.. then these experiences.. I am done.. I have a initial consult with a different surgeon, Dr. Frank Chae- I do not know what kind of revisions he does but I will find out.. and if I have to put a mask over my head and rob a bank I will..... I need to have this surgery revisied to a permenant metabolic , no holds bared , never again, WLS.

Needless to say, I would much rather have insurance cover this than do something quite illegal to cover the cost.. so I need a bit of help from you all that either have had it approved and / or already have had the surgery.

What did you have to do to get approved? What medical issues did you have for revision (if any)? How did you word your appeal, or orginial request for surgery. I need to write a letter of appeal and so I would like to write it correctly!

I see Dr. Chae tomorrow so any help asap would be awesome and VERY much appreciated!

Hi Butterfli2005,

I had to go to a second level appeal in order to get approved for band to sleeve revision.  I first started with the first level appeal letter.  That was denied, so I had to teleconference with several MVP reps for my second level appeal.  It was a little intimidating, but I made sure I had notes in front of me so I didn't miss any important points.  I think a lot depends on your insurance policy.  MVP is fairly strict and says "one WLS per lifetime", so I had to argue that it was not good for my health to just remove the band and not replace it with another surgery.  I have my appeal letter that I would share with you in confidence if it would help give you an idea of what/how to write it.  My surgery and situation is different, so you would need to of course change it to suit your personal situation.  It would however give you some ideas.  I did finally get approval, but I did have to fight for it. Also, be advised that obesity is considered a disease now, so I mentioned that in my appeal.  The fight was worth it, I am now able to wear regular sized clothing, and am wearing clothes in my closet that I couldn't wear.  I'm down 78 pounds total since I started with the lap band 10 years ago.  No more XXL's for me, unless for comfort :)  Best of luck to you!   

So I have been denied both by a request from one surgeon and then switched to another and was denied there too. I would love to see what you wrote.. My new surgeon (Dr. Chae is doing a peer to peer conference next week and I am not planned to be there since it is peer to peer but any ammo I can take to Dr. Chae will be much appreciated. My email is [email protected] . Thanks in advance :)