Denied for Lap Band to DS Revision (x-post)

Lori F.
on 8/8/11 12:05 pm - Chula Vista, CA
Shelli- That sucks. Don't give in and don't give up! Remember everything that you've read here. I just found out that you can EITHER have an appeal OR a peer-to- peer. Ask your surgeon if he will do a peer-to-peer for you BEFORE you appeal. The peer-to-peers are more successful that appeals on paper- it's easier to say no on a piece of paper than to a person. See if Dr. Sudan will do it for you!
Pre-band highest weight: 244
Pre-band surgery weight: 233
Lowest: 199 ( for, like, a day)
CW:
260 (yes, with the band!) 
Current Fill: 5cc in 10cc band
BMI: 49
Band to DS
on 8/8/11 1:35 pm, edited 2/3/12 10:28 pm
Unfortunately, I had to delete this post due to privacy concerns.

Got a lap band in 2008. Tried hard, but didn't lose much weight & developed swallowing problems. Fought my insurance company for almost a year & finally had a band to DS revision on 5/11/12. Have now lost 125 pounds. Yay!

Lori F.
on 8/8/11 2:43 pm - Chula Vista, CA
 Do ask because the peer-to- peer thing was NOWHERE in the options they gave me.I found out about it on OH!  I guess they expected that my surgery coordinator would know about it. I also am thinking about paying for the removal myself like the other poster noted and just asking for approval for the DS. What do you think about that?
Pre-band highest weight: 244
Pre-band surgery weight: 233
Lowest: 199 ( for, like, a day)
CW:
260 (yes, with the band!) 
Current Fill: 5cc in 10cc band
BMI: 49
Band to DS
on 8/8/11 11:09 pm, edited 2/3/12 10:28 pm
Unfortunately, I had to delete this post due to privacy concerns.

Got a lap band in 2008. Tried hard, but didn't lose much weight & developed swallowing problems. Fought my insurance company for almost a year & finally had a band to DS revision on 5/11/12. Have now lost 125 pounds. Yay!

Band to DS
on 8/9/11 4:38 am, edited 2/3/12 10:28 pm
Unfortunately, I had to delete this post due to privacy concerns.

Got a lap band in 2008. Tried hard, but didn't lose much weight & developed swallowing problems. Fought my insurance company for almost a year & finally had a band to DS revision on 5/11/12. Have now lost 125 pounds. Yay!

Lori F.
on 8/9/11 6:49 am - Chula Vista, CA
 I'm so glad that someone can benefit from MY blunder! Make sure you let us know how it goes!
Pre-band highest weight: 244
Pre-band surgery weight: 233
Lowest: 199 ( for, like, a day)
CW:
260 (yes, with the band!) 
Current Fill: 5cc in 10cc band
BMI: 49
butercup
on 8/8/11 2:29 pm - Kennewick, WA
Could you get an approval for a DS and pay for the band removal out of pocket? That's what Stephanie is doing. Her insurance wouldn't pay for a revision.
Band to DS
on 8/8/11 11:13 pm, edited 2/3/12 10:29 pm
Unfortunately, I had to delete this post due to privacy concerns.

Got a lap band in 2008. Tried hard, but didn't lose much weight & developed swallowing problems. Fought my insurance company for almost a year & finally had a band to DS revision on 5/11/12. Have now lost 125 pounds. Yay!

honeybadger 11
on 8/9/11 1:33 am - FL

I was actualy think about you case last nite and the dismotility ABSOLUTELY makes it where the band has to come out so you should not have to pay for that at all. If it is just the BMI over 50 im not worried at all that you wont get it, they my make you jump thru more hoops but it will be worth it in the end!

I will continue to swing amadillos for you:) haha

~Jennifer
Revision to DS 11/9/11                                  LapBand 12/2006
SW  321/ CW 248/ GW 185                           SW 330/ HW 348/ LW 300
Join me here: http://weightlosssurgery.proboards.com
        

Band to DS
on 8/9/11 4:48 am, edited 2/3/12 10:29 pm
Unfortunately, I had to delete this post due to privacy concerns.

Got a lap band in 2008. Tried hard, but didn't lose much weight & developed swallowing problems. Fought my insurance company for almost a year & finally had a band to DS revision on 5/11/12. Have now lost 125 pounds. Yay!

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