Highmark BCBS
Hello - I am hoping to have revision from sleeve to bypass. My insurance is Highmark BCBS. Anyone been approved by them? Any trouble? What documentation did they require? In other words, what hoops do I need to jump through.
I am having a revision due to severe GERD and weight gain. I have Barrett's esophagus and surprised my original surgeon even recommended the sleeve.
Thanks!
Just adding to this post. I have Highmark BCBS and my policy states I have a "one per lifetime benefit" restriction. I had to have my lapband removed in January due to failure/slippage/hernia and GERD.
The Dr. wanted to wait 3 months after band removal to heal them do the RNY. The insurance paid some of my band removal claim and denied a portion within the same claim for the Operating room time stating that I used my "one per lifetime benefit" stating the 2 codes used were weight loss related. How crazy it this???
So I haven't had WL surgery and my band removal is considered my one benefit per lifetime. Of course I am appealing but not sure how this will shake out.
Frustrated!!
Julie
