Insurance Approval
I'll try to make this as short as possible. I had the lap band in September, 2012. I lost 30 pounds only to gain it all back. My whole lap band life was filled was constant fills and unfills. I never got any restriction and when I did, I couldnt keep anything down. During this time, my dr at the time had some legal issues and was in jail and had his medical license revoked. I had no place to go and did not know how to find my records. Evenutally I did track down my records and had them sent to a new drs office. I continued to have more and more trouble keeping things down although by this time I had very little fluid in my band, so I'm not sure what the trouble was. He only did an xray at the time and said the band was in the right place. He suggested I give it some time and think about it as he did recommend keeping the band as more and more people were having trouble with it giving them long term success, but it was really up to me. I did give it some time and decided to have the band removed as I was continuing to have more trouble with it. He suggested a revision to the bypass as in his opinion would give me the help and success I was looking for. I decided to go with his suggestion and have the band removed and attempt to get the bypass done. The insurance dept at this new dr's office, told me I needed to do the 3 month nutrition and exercise classes and a new psych evaluation, which I did. By this time it was August, 2016. At the end of all that when I though I was to the point where they could submit it to the insurance company for approval, I find out that the hospital this dr is in is not a Blue Distinction Center of Excellence, which my insurance requires and my only option was to locate another dr and facility that is. So I did. In January, 2017 I had my first appointment with the new dr, have done all this dr required in addition to paying a $250 program fee which neither of the other drs had. After original submission by this new drs office, I got a denial as not medically necessary, so frustrating, but my case worker did appeal. I finally got the call last week, April 4, from the insurance company that the appeal was overturned and it was approved and they would send out letters to me and the drs office. I advised the drs office but was told she has to receive the actual call or letter before they can schedule the surgery. I'm so anxious and its so hard to wait. Its starting to feeling like it will never happen for me. After all this waiting, I guess I want to actually see it in writing that I am approved. I've been calling the drs office and the insurance and still nothing. Anyone else having any trouble like this?
