Self Pay to Insurance Approved Questions???

kac1973
on 8/15/16 2:51 pm

So I had Lap-Band 12/2006 (self pay) lost about 70 lbs and then gained it all back. Here I am 10 years later and now finally I have insurance that will pay for surgery. (BCBS of AL.) My question is If I am having a revision do you think I really have to go through all the hoops as they say to get it approved? Yes my surgery was self-pay but my BMI was the same then as it is now which is 51.  

Gwen M.
on 8/16/16 7:58 am
VSG on 03/13/14

No one can tell you this - you'll need to ask your insurance company.  

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

ladygodiva1228
on 8/16/16 12:08 pm - Putnam, CT
Revision on 02/04/15

I know I had to go through everything again for my revision and I had Cigna. 

Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150

Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl

    

bandgirl
on 8/17/16 10:09 am

I have Cigna and looking at a revision from the band.  Can you tell me a little about the process you had to do and how long it took?

ladygodiva1228
on 8/17/16 10:20 am - Putnam, CT
Revision on 02/04/15

I had to start by going to my surgeon's seminar and then set-up my "first" appointment with him.  I had to go to three dietitian appointments, a psych eval, upper GI scope, ultrasound of my abdomen.  I didn't need a sleep test thankfully.

It took almost a year before they approved me as I was denied three times even with a peer to peer and it went to the national appeals for Cigna.  They finally approved the band removal and revision to bypass.

Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150

Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl

    

bandgirl
on 8/17/16 12:04 pm

My surgeon already took out my band. I have had the GI scope and ultrasound of my abdomen hopefully this will speed up the process.  I had an emergency band removed.  Are you glad you went with the bypass?  I'm looking at the Sleeve, but I have already made one bad choice I want to make sure I make the right choice this time.

Patty R.
on 8/17/16 6:53 pm - Harrisville, RI
RNY on 09/08/16

Hi.  I have BC/BS and I am going thru all "the Hoops" for the 3rd time, and I have been approved. Had xtra test this time--Esophageal Manometry, band can and did cause damage that can be permanent.  :( 

BMI 44--> 35--> 43.8

Band in 2007--Band out 2013, revision to RNY unable--2016 RNY (will get date this Friday)

 

Good Luck!!

Lap-Band 2007 out 2013 RnY 2016 Age 64 5'6" HW 294 SW 284 LW 214 CW 235.2 goal 199

G. Dean Roye, MD FACS

Patty

brneyezz45
on 10/13/16 6:38 pm
Revision on 10/18/16

I have BC and I had to to repeat somethings per my doctor but insurance I did not have to do anything.

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