SURGERY DENIED AFTER PEER TO PEER

I also have KHPE and going for a consult to have a revision... I have spoken to my insurance company on 4 different occasions and they told me as long as its medially deemed it will be covered. I had lap band in 2005 and in 2008 i wanted a revision and it was denied because only one weight loss surgery was covered in a life time. Since then with the new health care reform laws as of Jan 2014 they will now cover a second surgery. I will keep you posted as to what happens side we have the same insurance

okay so this is what happened? my dr submitted my information in nov-dec 2013 which it was denied then my dr had a peer to peer and they told him to wait until the new yr 2014 bc things were going to change so we did re-submitted my paperwork for removal of the band and revise to vsg..everything was denied they won't even remove my band saying its not medically necessary..so i hope ypu have better luck then i did bc even with the issues i'm having with the band gerd, consitpation, pain around the port area etc they still denied everything..ibc is making it really hard since they don't have the one surgery per lifetime clause anymore...

what was the reason for denial. Do you have co morbidities? have you tried to appeal. Who is you Dr? I will keep you posted????

not medically necessary so they won't even remove the band...

Did you hire Lindstrom? I did and I am 3 weeks out from my revision.

yes i did so i'm waiting to see what happens

Don't worry if you don't hear from the Lindstrom's for a while. They will contact you each time they either do something, or hear something. The hold ups on my appeal were from the doctors office- waiting for files. The first appeal they filed was denied, they refilled and within 2 weeks I had my approval. Good luck!

yes i was worried bc i haven't heard from them but i have faith in lindstrom and i believe everything will workout in the end...praying and fingers crossed