Information submitted to insurance company on Thursday, January 12, 2017..praying for an...

2ndchanceGS
on 1/14/17 6:34 pm

So my information was submitted to my insurance company on Thursday I have Carefirst of Maryland, I know that they typically require a 6 month nutritional program but I continue to vomit and suffer from horrible heartburn with no fluid in my band so my Surgeon is trying to get approval based off of medical necessity.  I am hoping to have my lap band removed and converting to the sleeve.  Has anyone had any success getting an approval from Carefirst?

rachelp
on 1/17/17 8:38 am
VSG on 08/01/16

I have no helpful info but I just wanted to wish you good luck! I hope everything works out for you.

Sleeved 8/1/16

HW 285 / SW 276 / GW 160

 

 

breathemusic
on 1/18/17 11:17 am

Mind if I ask where/what surgeon you are using for your revision?  Did he do your initial band?  I have a friend who has had the band for years and it's not been successful. He's sick all the time, etc and can't keep down many of the foods that we're supposed to eat.  He's interested in looking into a revision but I hear that many docs won't do a revision if they didn't do the initial surgery, but he moved to this area after getting the band!

 

I truly hope that your insurance accepts the push for a shorter timeline!

2ndchanceGS
on 1/18/17 12:33 pm

Dr Kuldeep Singh is my surgeon he did my original band and I have been approved for the revision

2ndchanceGS
on 1/18/17 12:36 pm

I hope your friend gets some relief I know how he feels

Lauren010110
on 1/23/17 6:52 pm - Victorville, CA

Have your friend contact ObesityHelp member Services... I've had friends call and they've helped with finding a referral and insurance verification. I found the number for you 866-957-4636 option 1 I believe

annjones
on 1/23/17 8:00 am - Kansas City, KS
RNY on 02/13/17

I'm in a similar situation.  Initial insurance reply was No, I have Tricare.  But it is up for appeal and I'm hopeful, because i fit the exceptions stated in their rules.

 

I was banded in 2008 and had it removed in July 2016 due to Band failure.  

 

 

Ann Jones
HW-304/SW-295/CW-226/GW-200

RNY Surgery 2/13/2017
12/23/08 Band Date - Removal Date 08/15/16

Lauren010110
on 1/23/17 6:57 pm - Victorville, CA

Best of luck to you! I had to go through hoops (I am in California) for my revision. They only wanted to pay for the removal of my band because it was medically necessary, but deemed the revision to RNY a cosmetic procedure and I would have to pay out of pocket... up until two days before my scheduled surgery (I had already paid cash for my revision, to my surgeon, anesthesiologist, and hospital) I finally received a letter from my insurance company indicating that my Primary Care Physician went to bat for me and sent a personal letter indicating that I needed this surgery and it was in fact medically necessary. I feel if I didn't contact every one of my medical team and lobby for myself it wouldnt have been approved. I thankfully was reimbursed, but I jumped through many more hoops for that... 

My revision was the second best decision of my life... my initial WLS was the first. I will be sayin a prayer for you!

Most Active
×