BCBS FEDERAL REVISION FROM VSG TO RNY

Hey I am super excited received my approval from BSBS Federal in 5 days.

That's great!! Congratulations!! I hope my approval will go through quickly as well. Good luck with your surgery, and let me know how things are going with you. :-)

Hello!

I am on the appeal process with Fed BCBS of TX!

What did it take!

I have had the same problems as you!!! Severe GURD!!! Its out of control!!!!

They have denied me saying that i need to meet the requirements of being morbidly obese for at least 2 years prior to revision!!!

I now have to appeal it myself!!!

Dont know what to do!!!!

Please any advice will be great!!!

Thanks

How did you explain this? This is a requirement for revisions.

Member complied with previously prescribed post-operative nutrition and exercise program

I just let the doctor know that I was following the nutrition and exercise program until I started having issues with the band.

Did you do your 3 months supervised diet? If so, did you use your PCP?

Yes, I did the supervised diet with my PCP.

Hello,

Stopping in to give an update on my progress. I completed the 3 month supervised diet with my PCP, submitted all of the paperwork from those visits, the prior 3 years of doctor visits that documented my height/weight at the time, the documentation of the severe esophagus erosion I developed when fluid was in the band, and also my sleep study visits. All of this was submitted to insurance on Monday 5/22. I heard back 2 days later that I have been approved for lap band removal and revision to sleeve. BCBS Federal is awesome!! My approval is valid from 5/24/17 - 5/24/18.

Due to travel obligations I have coming up in July and early September, I will be scheduling my surgery for either the last week in Sept, or the first week of Oct. I'm nervous about having surgery some time in June, knowing I have to travel in July. The same thing goes for August...I have to travel again in Sept and that is too close.

My goal for the summer months is to not gain any of the weight I lost these past few months, and try to lose a little more before surgery. :-)

Dee

CurvyCakes,

I hope all is well with you. I've been wondering how you're doing since your surgery.

Hi,

So happy for you and your revision!!!

It's been a very long time since I've been on line here. I had the Lap Band surgery done back in 2008 and BCBS Federal did cover my surgery.

The LB did not work for me at all so I had it revised to the VSG (which I paid cash back in 2009 because BCBS Federal did not cover it). I never should have had the VSG done, it worked a little while then I gained back my weight and I have really bad hiatal hernia which gives me severe acid reflux.

So now 2017, I am interested in getting the RNY because I was told the acid reflux will not be an issue after that.

Don't know if they will approve me. I asked before about 3 years ago and they said no because I did not comply with the program. They will only pay for one surgery per life time. I'm going to try it again anyway and tell the I have this horrible hiatal hernia and severe acid reflux which I heard can turn to cancer. Maybe they will consider. Any thoughts?

Again, congrats on your revision! Blessings to you!