Question:
Has anyone fought their insurance for Lap instead of Open?
If you've been approved for RNY but your insurance will only provide an Open surgery and you feel Lap is better for you, did you fight for it? What was the outcome? How did you go about it? Is there anything you'd do differently if you had the chance? My surgeon supports a Lap procedure. I feel its right for me, so I'm fight for Lap! Open will still be an option, but not my or my surgeon's first choice. Why settle for anything but Lap!?! — ERICK B. (posted on June 6, 2002)
June 6, 2002
A lap procedure whether done for RNY or DS is more costly.
The reason being more time is needed for the surgeon to do the operation
with Lap then with Open. The surgeon can bill more operating room time with
lap because it takes longer and the patient is happy with less scaring.
Insurance compaines want to pay the least amount of money they can.
Kathi
— Kathi S.
June 6, 2002
Although the Lap procedure is more costly, the # of days spent in the
hospital for recovery is generally shorter, so you could possibly argue
that the total cost could end up comparable. Appeal to the board of review
for your insurance company, site any evidence you may have that shows if
you scar excessively, or you heal slowly. Have your surgeon write a letter
expressing his reasons (medical, not financial) for preferring the lap
procedure.
— Heather K.
June 6, 2002
Insurance companies have also reported that more complications occur with
Lap then with open. It stands to reason that they can see better with you
opened up right in front of them then with a wee camera.
Good Luck fighting..:)
Kathi
— Kathi S.
June 6, 2002
Lap can be more costly because of the high tech equipment, tools, videos,
etc. that is required. Also, a surgeon who is skilled enough to perform
Lap is going to be a higher price too. However, the concern about being in
the OR longer or being under longer is no different with lap then it is
with open if you have a good surgeon. I know everyone thinks their surgeon
is the best... Dr. Champion in Atlanta can perform lap RNY in under an
hour... When you're good... you're good... and you will never find a
negative thing said about Dr. Champion. I will email you a letter that I
sent to my insurance explaining why I chose lap over open.
— juliehedges
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