Second denial
Well I got my second denial and their reads this time was that I can't prove that I've been having trouble with reflux bc when I asked my dr a long time ago for medicine for reflux they checked my insurance and they do not pay for ppi medicine bc they make so many great over the counter meds now. So I've been taking over the counter . And she said that I have no proof that I've tried real nutritional changes which I explained to her that it's tough to make good choices when you are physically unable to keep down any protiwn or veggies. Do I need to remind them that I've have no problem maintains my 100 lb weight loss until this band crapped out on me . Their reasons are bull crap and have nothing to do with my policies written contract that states that a revision is covered if a surgical or medical complication is clinically documented and they have that with a letter from my gastroenterologist that says my Problems are from my band . My balloon of hope is deflating but I have one more shot . Ugh feeling depressed
Well I got my second denial and their reads this time was that I can't prove that I've been having trouble with reflux bc when I asked my dr a long time ago for medicine for reflux they checked my insurance and they do not pay for ppi medicine bc they make so many great over the counter meds now. So I've been taking over the counter . And she said that I have no proof that I've tried real nutritional changes which I explained to her that it's tough to make good choices when you are physically unable to keep down any protiwn or veggies. Do I need to remind them that I've have no problem maintains my 100 lb weight loss until this band crapped out on me . Their reasons are bull crap and have nothing to do with my policies written contract that states that a revision is covered if a surgical or medical complication is clinically documented and they have that with a letter from my gastroenterologist that says my Problems are from my band . My balloon of hope is deflating but I have one more shot . Ugh feeling depressed
check out Lindstrom obesity advocates. They are a law firm that helps overturn unreasonable denials.
I forgot about Lindstrom they have done wonders for lots of folks! I wish you the best. Can you get a copy of the visit where you complained about the heartburn and the doc said to use OTC stuff. That would at least show you had complained about it. I would also try writing down starting now what you can eat. Write down what healthy food yoiu haveried to eat and then what you end up having to eat because of the problems and wrote when you end up vomiting. Maybe try drinking protein shakes hen you can't get food down. I still have to use them because the band messed up my stomach and there are days I just can't eat so I'll drink shakes just to get some nutrition in. Keep pushing hon, good luck!!
Thank you so much. My insurance company has record of my first complaint of it, but I just can't prove that I've been taking it. For some strange reason, ever since my egd was done I have been able to eat a little bit better . He did not report that he dialated my esophagus but I feel like he may have because he said it was structured because of the reflux. I am so sorry the band caused you damage that was not reversible . It's sad because we all started out on this journey with hope of a better quality life and the band did not deliver on its promises. As I look back, I'm sure many of us would have taken a different path to try to achieve our goals . Sad .
