Appeal and gastric reflux problems

Carmen C.
on 12/5/11 8:24 am, edited 12/5/11 8:33 am
RNY on 08/08/12
Has anyone won  an appeal for this reason...

I have a hernia and erosion in my stomach due to VSG, they are requesting RNY for permanent resolution. It has totally damaged my esphoguas and intensinces.

IT is causing acid to possible go into my lungs at night. .

My doctor is writing a letter to the appeals department directly asking them to approve me ASAP. has anyone everyone won this?? My doctor says they don't see a reason why they will not let me have this surgery due to be possible getting liquid in my lungs. Anyone else have this?? Aspirate stomach acid into my lungs and cause pneumonia (my doctor is writing to the appeal department directly)

If I don't win I have to suffer with this for another 10 months. - before I qualify. There is a 2 year waiting period and I am still have to wait til August 2012
Tonya0531
on 12/5/11 9:50 pm - Lake, MS
I'm not sure about the VSG, but I will tell you that the band was giving me similar problems.  My doctor said that it was definitely good to have some problems caused by a previous WLS in order for insurance to pay for a revision.
Tonya
HW: 274  PreOp Diet: 271  Surgery: APRIL 25, 2011   
LilySlim - (6Jve)
I love my new life!!!
Sunbunnyqt
on 12/5/11 11:56 pm - FL
I have no experience in such an appeal but I think the insurance company has to take these conditions with your acid reflux very seriously. Aspirating into the lungs can cause serious damage you do need this surgery asap. You are in my prayers.
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