Question:
Have anyone been approved for the VSG surgery from BCBSNC?

I was in the process of having the VSG surgery,but I was denied,because the insurance company said that it was experemental.I sent my denial papers to my surgeon office,but has not receive no response.What should I do change surgeon and producre or change producre and keep surgeon? I really do need this surgery,because it is a life and death situtation and I am ready to get the ball to rolling! What should I do,because I am so confused?    — brainey62 (posted on January 17, 2009)

January 17, 2009
Who suggested VSG to you? Your physician should have gone over all of the options and you would have been able to chose one that your insurance company will pay for. Go back to your surgeon and talk to him.
   — susangielda06

January 17, 2009
I would have your doctors office appeal it for you, I have BCBS of PA and had the VGS done, was approved the first time, Good Luck to You.
   — [Deactivated Member]

January 17, 2009
Don't give up. I am sure the insurance sent a copy to the doc office of the same paper work you got. I to have BCBSNC and was denied the lapband about 3 years ago next month. My doc office appealed it and it took 2 appeals but they finally approved it. So dont give up and hang in there. Where in NC are you located? Email me, I would like to know who your doc is. [email protected]
   — Babbles

January 17, 2009
When I was investigating surgeries, BCBSNC would only approve RNY or Lap Band. If it is the state employees branch they are very firm on that as opposed to BCBS regular which seemed to be a bit more lenient. Write lots of letters, send lots of pictures and ware them down. Appeal until they are sick of you. Good luck.
   — ceecee127

January 18, 2009
I don't have the same insureance but my sergeon said we can try for it and it came thru. It is ten years old but not well liked by the insureance companies. I also have only one Kidney and that was the reson for the VSG. Your surgeon would have to fight it out as well as you. Good Luck to you. It has worked great for me I have lost 60 lbs since my surgery Nov 3. The Band is the other choice though I like the vsg and don't realy know any more than what my friends tell me about the RNY.
   — Scott Ambrose

January 19, 2009
I would have your surgeon appeal it for you; if in fact that is the correct procedure for you. You need to get a second opinion if necessary. Good Luck and God Bless, vinnigirl, retired RN
   — vinnigirl