Question:
Have you been turned down for DS, but approved for RNY?

My ins company (BC/BS of TN) received my LOMN yesterday. This morning I got a phone call from them saying that I was being denied for the BPD/DS, which is what I had decided I wanted. They denied it because they say they consider this type of WLS investigational/experimental. They went on to say that I would be approved for the RNY or VBG when the doctor re-submits the LOMN. My question is- Has anyone been denied the DS and proceeded to have the RNY? Or Did you fight the insurance company to get the DS? Were you happy with your decision? Thanks in advance!    — Tina K. (posted on November 29, 2000)

November 29, 2000
Tina, Yes, I was initially turned down for the BPD/DS by BCBS of CA. They said they would approve the RNY and VBG though. My doctor had to call and explain the BPD/DS to the insurance company doctor and within 20 minutes after that call, I was approved. They did not state though, that the procedure was experimental, only that they were not really familiar with it. Good luck.
   — Barbara H.

November 29, 2000
i have heard of some insurances not approving the DS for that very reason, experimental. All the DS folk, I'm sure will state facts to try to argue that point. But until a procedure has been endorsed by the National Institutes of Health, which they only two WLS ever to be endorsed are the VBG and the RNY.........Good luck in whatever you do....
   — Jack N.