approval for a revision

I had open RNY in 2000 by Pacificare or Orgeon. I did not get the surgeon I had chosen to do it. My insurance carrier said no to him but agreed on another surgeon. This man was a surgeon and an oncologist. He had been trained to do open RNY by his office partner. I had a goodly amount of weight loss after surgery and lost about 110 pounds. But, I have since gained almost all of that back. Since the surgery I developed a huge hernia and the pouch has disrupted as well. I went to a physcologist, had a sleep study done and saw a nutritionist, all approved by my insurance company. The insurance company has refused a revison as they deem it not needed and not medically necessary. My BMI is about 58 so I am still obese. The surgeon tried to get my revison approved even though he is no longer doing any of these surgeries any more. He said that he would do my revision if I was approved.

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