Overstitch and Insurance Approval

nickie2524
on 2/12/18 1:58 pm, edited 2/12/18 2:08 pm

Wondering if anyone has had any experience with Blue Cross & Blue Shield of California covering the overstitch procedure due to weight gain? Thanks

swtmelissa
on 2/13/18 6:35 am - West Allis, WI

Curious, what is an overstitch procedure?

nickie2524
on 2/13/18 7:21 am, edited 2/12/18 11:26 pm

The doctor goes in and basically makes the pouch small again if it has stretched. I had surgery in 2006 and have gained most of the weight back i originally lost. I only lost 50 pounds with the original RNY. I'm having my egd Thusday so the doctor can see whats going on.

cuttinojo
on 3/13/18 8:52 am
Revision on 04/04/18

I had RNY 10/31/2005 hoping to have a revision my Doc did my EGD 2/14/18 and he told me that my pouch has completely stretched and something with the Stoma he said 2 things and they can be fixed. went back for my appt the following week he suggest that I get Lapband he said that way I can control how my weight. the band can get tightened or loosened. I have cigna and the coordinator who sends off the things to the insurance told me that Cigna only requires one psych visit and 4 dietitian visit I already had 2 my next one is 3/19/18.

nickie2524
on 3/13/18 9:05 am

My doctor sent a prauth for the band and my insurance came back and denied it as experimental. They approved the overstitch my surgery is 3/20.

cuttinojo
on 3/13/18 9:47 am
Revision on 04/04/18

I had RNY 10/31/2005 hoping to have a revision my Doc did my EGD 2/14/18 and he told me that my pouch has completely stretched and something with the Stoma he said 2 things and they can be fixed. went back for my appt the following week he suggest that I get Lapband he said that way I can control how my weight. the band can get tightened or loosened. I have cigna and the coordinator who sends off the things to the insurance told me that Cigna only requires one psych visit and 4 dietitian visit I already had 2 my next one is 3/19/18.

sheesh
on 2/21/18 11:27 am

Insurance paid for overstitch However it did not work what so ever!

I had RNY in 2005

SW 265

GOAL IN 2006 140LBS

2015 180lbs This is when i went in for the Over Stitch bc bs aproved Yeaaa so happy

Well the surgery was a fail !!

It had no results ! It was my understanding that i would have that feeling of not eating / fullness after eating like I originally had in 2005 after Gastric RNY .

The first week after over stitch I had such a Bad Sore throat That i didnt want to eat LOL

The procedure calls for several scopes to be placed down your throat and that it where the sore throat came in to play .

So I lost 10lbs that was it !

Nothing changed Meaning no full feeling , no signal saying im full UGH

It was a huge fail for me !

Im sorry to be a downer But I just want to share my story hoping to help .

I have maintained my weight meaning i haven't gone over 180 , I am now at 172lbs went down to 162lbs last year

But here i sit Searching for a revision to help me get to 150lbs

I wish you all the best and I honestly pray that the overstitch works for you !

Peaceful Blessed Day To You

nickie2524
on 3/13/18 9:07 am

Oh no... Hopefully it works.

Kathyjs
on 3/2/18 9:07 am

IMHO you sure don't need surgery to lose 12 pounds. Cut down on your portions. I will be kind and shut up now

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