Soli3l

Good evening, I am unsure if this is the correct forum to post my question, if it's not I apologize ahead of time. I wanted to know if there is a sample letter or template regarding Medical Necessity for VSG Revision due to complications. Such as: Letter from Patient to Health Insurance or Letter from Doctor to Health Insurance. Your assistance is greatly appreciated. Thank you. SoLiEL

sounds like but I am having an endoscopy in a couple of weeks to confirm complications

When I had Lap Band and Sleeve I had Cigna, they denied my Sleeve but I appealed with my doctor and got approved. Now I have FL Bcbs but no bariactric benefits so in order to get revision approved their rep said I can mention morbid obesity or any co morbidities, only medical complications to see if I could get it preauth.

I have been through the denial process when I was going from lap band to vsg. I called insurance found out reason for denial and then followed the steps with my doctor to get it approved. It is stressful... My Issue right now is that I need revisión surgery but my insurance does not have any bariatric benefits. But any revisión with médical necessity not morbid obesity can be covered. I've got letters from doctors recommending the revision but state morbid obesity and this does not help with my approval as my revision has to get preauth. I'm trying to do the leg work myself because who better than yourself can get the ball rolling?

So sorry to hear...wow...

I hardly post for that same reason...it's not worth my time or aggravation. Brandeett you've been through the same experience?

That is correct.

I have this insurance and they offer no bariatric coverage.

I am getting an endoscopy done next month to see what is wrong with my sleeve which will most likely need a revision. My current health insurance has no bariatric coverage. Is there any insurance that I could self pay for my revision? My other option is cash pay for this surgery. Thank you.

I live in NJ, I am speaking with my claims administrator at work to see if they cover due to complications she is checking with BCBS. Going to MX is not an option. I know cash pay may cost $20k. Thanks for your feedback and support. ????

New hope again for me. I went to see my new surgeon, I explained my history and the amount of weight lost. I am scheduled for an endoscopy the last week of August to see if he will need to redo my sleeve. Since I had a lap band prior to sleeve, it stretches the top of the stomach leaving like a handle on each side, when it is converted to a sleeve, sometimes the surgeon leaves it too big, causing technical failure. With the endoscopy he will see what is wrong with my sleeve. The staff is so nice...and the object of the nutritionist is to get me off my diabetes medication and for my weight to drop within 6 months. I am more excited of getting off my diabetes medication as I have family members that have died due to this illness. So I am excited and no longer feel like a failure. Woot!! Woot!

It turns out that I might have a complication with my sleeve, I'm scheduled for an endoscopy. When a lap band is on your stomach it widens the sides like ears on your stomach, when it is converted to a sleeve, the surgeon might not cut the necessary amount leaving a big sleeve that leads to technical failure.

Makes sense what Dr. Weiner says, I ordered the book. THANKS SO VERY MUCH!!!

Thanks again...much appreciated!!!

Wow...thank you so much for your insight, I am aware that WLS does not do anything for thyroid problems, I am diabetic and the surgery didn't help that either. However, I never thought about this way, but your soo right..."I’ve learned that your rate of success is not determined by the size of your sleeve or even choice of procedure. The quantity of food you eat is not near as important as the actual food choice. " I will also look at the videos you posted they sound great.

I have an appt with a new surgeon on Monday whom specializes in diabetic and thyroid patients, little did I know that my endocrinologist works with this surgeon. But this surgeon was recommended by a friend whom had a sleeve with my same health conditions. Maybe it's time to see a new endocrinologist and a different surgeon. Fresh eyes may be helpful.

A member told me that I had to post it here...then another said don't, but was already posted....I am trying to find members that have been through my experience and what have they've done. Is there a way to delete all of my posts? Sorry to inconvenience you.

IDK either, but I will be getting checked to see what can be done and see if I can get an answer. My concern is that being the same surgeon performed both surgeries, maybe something was not done correctly. Thank you for your feedback I don't know what is causing your lack of weight loss. Not even close to having enough information to comment on that. But FYI, not losing weight after WLS is not a "complication." A complication (as the term's used around here) is something physical that goes wrong during or following surgery that is sometimes (not always) life-threatening and requires further surgical or physical intervention and often more time spent in the hospital or another medical facility. This includes leaks, strictures, damage to other body organs during surgery, organ failures, infection, etc. So any "complications" threads here won't address your situation, as I understand it.

I am moving this topic to VSG Complications, I was able to find it, thank you.

I had the lap band in 2010 lost only 16 lbs, had it removed Oct 2012 Doctor said it slipped, had Sleeve done Nov 2012 lost only 20lbs. I do have hypothyroidism and diabetes. My Thyroid is under control, my diabetes it varies. I am going to see a new surgeon on Monday to see what else could be done...and what type of revision.

Thank you for your post, I have not lost hope...I finally was able to find the complication forum. I did research various forums to see if others have gone through this and what options they have tried.

I do have an endocrinologist that treats me and has run special tests on me, also, I have a nutritionist that has been working with me since 2011. My issue has never been that I eat alot, which is the weird part. Hopefully, I will get this mystery resolved one day. Thank you for your support and your post.

I got the lap band in July 2010, lost 20lbs and no more. In October 2012, they took the lap band out and in November 2012, I got sleeved. 13 months later, I am still a diabetic and my total weight loss with sleeve was 25lbs. I started my sleeve journey at 246 and now weigh 221. I am thinking that I should've gotten the gastric bypass and I'm considering that option, but my new insurance does not cover bariactric surgery. My surgeon states that my diabetes prevents me from losing weight...I am so frustrated, I tell him will i be the first patient to have all 3 surgeries? DId anyone go through this? Thanks.

Hi Blinky, I recently joined a gym and I'm giving that a try, I'm trying my best for high Protein low carb, but it's not easy. My nutritionist told me to try Gluten Free food, I also have some Vitamin deficiencies she states it's hindering my weightloss, therefore, she has increased some Vitamins and lowered others. Thanks for the follow up, I appreciate it. Wish you the best in your journey.

Thank you Moonlite, I did lose some weight when i did the Atkins diet 20 carbs daily. Thank you for your input, I guess I lost hope and I thought the issue was just my sugar which is what my doctor and nutritionist emphasize.