Question:
insurance issues with revision from lab band to ryn
yes oh friends seen the surgern yesterday and he had agreed that i need to do a revision form lap band to rny did any of you have to get the clearences from the heart dr and your primary dr and the but dr to do the surgery? i am so ready for the surgery had the band 5 months and this past 2 months its been hell for me i m so ready for the revision just wanted to knwo if any one else had to do all the clearnces for there insurance company to have it done again ty for all you help oh family sincerely samantha — booboo121573 (posted on May 19, 2010)
May 20, 2010
How bad do you want the revisional. If you really want it, you'll do what
ever the insurance request of you. That's if you want them to pay for it?
— Michael Eak
May 21, 2010
First let me answer your question. No, I didn't have to have all those
clearances but what one had vs what your insurance is requiring of you
don't really matter much in the grand scheme of things. While Michael was
pretty blunt with it, he is also absolutely right. The insurance company
CAN require clearances IF they are going to pay. None of us know your
medical history, there may be a reason why they are doing this. On the
other hand, it may be a test to see how bad you want the revision. My
surgery was a mechanical failure through no fault of my own yet they still
fought it at first saying 1 surgery per patient per lifetime. Period.
Fortunately, I went with a place who has an excellent tract record with
getting approvals and in the end they were able to make the insurance
company see reason (meaning I did not outeat the surgery or do anything to
sabotage it, I simply had a fairly rare mechanical failure) and they paid
for it. But that is my story and means nothing to your story. In the end
Michael said it. Unless you want to pay for it out of pocket (and who
does?) you pretty much have to do what is required of you, otherwise you
can be denied. Anything worth having is worth waiting for and working for
but I wish you all the best getting these clearances quickly so you can
have your revision.
— Kellye C.
May 21, 2010
its nothign to do with insurance yet i am doing the clearances agian to
make sure i have them all so if insurance asks for anything else just
wondering if anyone has done this before i am not eatign out of my band
surgeon feels with as much weight as i have to loose its better for me to
do the bypass and with my health issues to thanks all for the advise keep
it comming ty
— booboo121573
May 23, 2010
I am on medicare and am going from lap band to rny. I have to have my
heart cleared plumuary cleared and also stomach checked for a certian type
of ulcer. Then my insurace is good to go.
— pandavenise
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