Insurance will approve sleeve but not band removal?

(deactivated member)
on 5/16/16 2:15 pm

Well then the appeal would be for the surgery type you want.  They can't say you would lose too much with a sleeve because bypass and VSG lose about the same amount.

 

Just be careful that you don't use up appeals for the wrong issue.

Jamie Z.
on 6/1/16 5:41 am - MI

I haven't had any luck yet.  Insurance keeps claiming they have not received any paper work (I've seen multiple faxes my dr has sent). I have no denial to even appeal at this point...

        
Patty R.
on 6/6/16 11:47 am, edited 6/6/16 4:50 am - Harrisville, RI
RNY on 09/08/16

Hi   I have had some similar problems:  I had a band placed 5/07.  From  1/08 to 9/12 I had terrible "slip" symptoms and had every test known to man, but no slip, until I had an emergency chest cat scan for a Pulmonary Embolism. Low and behold, they found a band slip along with a lung clot!! ( Clot related to Lyme disease )  So then I needed to get approval for revision to RNY.  Waiting and waiting, faxing and faxing. Faxes sent to BC/BS, but wrong state!!! ( this what you need to check ) Finally got approval, oh yes here we go!!  NOT. Too much damage from band slipping around for 5 years. Now almost 10 years from where I started, I trying again for RNY approval!!!   

DO NOT GIVE UP. MAKE CALLS TO YOUR PLAN. Get fax number from who you speak to, not necessarily what's on your insurance card.      Good Luck 

Lap-Band 2007 out 2013 RnY 2016 Age 64 5'6" HW 294 SW 284 LW 214 CW 235.2 goal 199

G. Dean Roye, MD FACS

Patty

Jamie Z.
on 6/23/16 6:40 am - MI

I got good news last week!  Approved!  Now to just be patient until July 18

        
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