Tell me about your insurance approval for revision

GoDawgs1979
on 6/8/15 9:16 am

I'm scheduled to revise from band to bypass because I barely lost any weight, and I have Humana.  They asked for documented proof that I complied with my diet and exercise after the lap band.  I'm nervous that what I'm able to provide won't be enough.  I had a number of fills until I received the perfect amount of restriction.  The only records my lap band doctor has is the operative report and then a notation of each adjustment.  My last one was in 2009 and I simply haven't needed one since then.

I put together as much of my personal documentation as possible, whi*****ludes receipts for weight loss programs (weigh****chers, jenny craig, medifast, protein shakes, etc) and receipts for gym memberships.  I also even went through my facebook and printed out photos of meals that I cook and have posted over the years, as well as references in emails and on facebook to weight loss attempts.  I created a table of contents and organized everything I printed out by date.  

I also wrote them a letter stating that I initially went with the lap band, even though it has a lower rate of success, because I was only 25 years old and had no comorbidities.  Now I'm 36, have been diagnosed with PCOS and as prediabetic, and that I need to revise to RNY because of the higher rate of success and the assistance it provides for preventing diabetes.

I'm so worried that I won't get approved.  

If you revised for insufficient weight loss and health insurance paid, will you tell me about your approval process?  Did anyone have Humana?

Hislady
on 6/8/15 10:42 am, edited 6/8/15 10:42 am - Vancouver, WA

I haven't revised but it sure sounds like you have done everything you possibly could to prove it. I don't recall ever reading of someone putting together a booklet like that so kudos on a job well done. If that doesn't get it approved I doubt anything else will!! Best of luck to you!!!

GoDawgs1979
on 6/9/15 12:14 pm

Thank you!!  I went to my PCP today, who is very supportive of the surgery.  When I told her that I emailed her the booklet of my attempts and wanted to know if she would write a letter saying I was complaint with diet and exercise recommendations, and that she recommends the bypass surgery as medically necessary, she told me to write the letter myself, fax it to her, and that she'd sign it.  She said she knows I will be truthful about my weight loss attempts so she will just defer to me on what goes in the letter.  

Hislady
on 6/9/15 1:21 pm - Vancouver, WA

Looks like you have everything covered! Just remember sometimes they just automatically refuse the first try so don't be afraid to appeal if they do that. Some companies do it some don't you just never know!

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