Insurance & Revisions?

I had my surgery 13 months ago (VBG) and I have a SLD. The surgery only worked for about 6 months and I've spent the past 7 months struggling with dieting/gaining again. I'm just curious... how hard is it to get insurance to approve a revision? It would seem like if we are approved for surgery originally and it breaks down then the repair/revision shouldn't be a question. However, I had United Health Care last year and I have CIGNA POS Open Access (thank you employer!!) and I hear they are much harder to deal with. I'd love to hear how those of you who have had revisions have done with your insurance companies. Thanks! DeeDee

I am in the process right now I have S&S healthcare and I might have to go through the 6 month diet with a doctor I hate that I want this now so bad. I hope you get yours ok. let me know Julie

Hello, I had a vbg on 8/4/98 and tomorrow 8/3/04 i am having my revision to ryn and the insurance approved right away within a week... there is a new clause that will pay for revisions... i just had to get a scope done....so tomorrow morning is my surgery.....

Debra, What is the new clause about revisions? What insurance do you have? I gotta find that clause. Carla

HI DEEDEE, I AM IN THE SAME BOAT AS YOU I HAD A VGB DONE 06/23/03 AND IT WORKED GREAT FOR ABOUT 6 MONTHS, AND NOW NOTHING. I'M IN THE PROCESS ALSO WITH FINDING A NEW SURGEON.. I WOULD BELIEVE THAT IT WOULD BE EASIER TO GET A REVISION PRIOR AUTH, AS LONG AS YOU HAVE THE RECORDS TO BACK YOU UP. GOOD LUCK. KEEP ME POSTED, I HAVE AN ORIENTATION TONITE FOR A NEW SURGEON. WE'LL SEE HOW THAT GOES.

Hello... I have Blue Cross Blue Shield EPO...I had the approval before I even went to see the shrink.... but I had all my documentation from 98 everytime I had a scope done... I really did throw up just about daily..... I had a very hard time.... It is a matter of the surgeons office wanting to do the insurance work for you.... my new surgeon and his staff are the best.... they sent in the paperwork the same time I had my scope done and I was approved in a week.... I just started crying when I got the letter in the mail.... its been six years.... Good Luck... don't call the insurance, they note all the calls you make to them let the person in the doctors office who deals with insurance companies all the time do it.... they know what to look for and who to talk to.... Good Luck Debra

Hi, DeeDee: I had a proximal RNY three years ago. I lost about 75 pounds and stayed there for a couple of years. This past year, I've regained about 25 pounds. Blue Cross/Blue Shield approved a revision within two days of receiving the paperwork. Dr. Peter Crookes of USC in Los Angeles will do a revision to DS on September 16. Dale

I had a 'fix' not a revision. Had BCBS for the original surgery; and Aenta for the 'fix' It took about a month to get Aetna to approve the fix - and one appeal.