peer to peer with BCBS denied my distal rny revision

BCBS denied my distal rny revision x2. I was so upset earlier today when I got this news. Now, I'm ready to fight back. My next step is an appeal. I need advice from people that were successful with their appeal. I need all the help I can get, lol

For those that have DS, my GERD is why I'm chose a distal...but I haven't closed the door on a DS. I've had GERD for over 20 years and it did improve after my RNY, but now it has worsen as I've gain weight. I also had some urinary incontinence, which resolved with the weight loss and now has resumed with weight gain. Most of my weight gain has been abdominal, and I'm sure it's the pressure that has made both GERD and UI worse. (my volume of food has not changed, I eat around 10 oz).  

Is there anyone with a DS that had their GERD improve after weight loss? (I would treat my sleeved stomach the same way as my pouch, by meassuring my food) The closest surgeon that does these revisions is 5 hrs away in Va.

I appreciate any feedback.

Have you talked to the surgeons office. Usually they have someone on staff to help with the appeals. Keep working on it. Don't let this discourage you! It's part of the game they play. 

When the surgeon's nurse gave me the news this morning, she suggested that I google "BCBS revision appeal". She did not tell me there was someone on staff to help. I am discouraged, but not defeated.  I hate the game playing. I also have to get another surgeon, because mine is moving to another state. (His MD wife got a great position)