GA peach

I have the same type of hernia. I am a band patient who was hoping for the sleeve. Now the doctor has suggested gastric bypass. I'm now waiting for approval.

Insurance stated band didn't show any malfunction. So I guess vomiting & food getting stuff is not justifiable. I'm so irritated & stuck with this piece of plastic until I can get something done. I plan to appeal. ..any suggestions on how to write the most justifiable reason to get this thing out of me. Thanks in advance

Had all my fluid removed from my band last week and had an upper GI done today. Although its not official, the tech did show me I had reflux which is why food seems to be stuck. It was rough trying to swallow the barium. I'll have to wait for the doctor's official report. I'm hoping & praying that will now be enough proof for approval for the revision.

Ok thanks!

Yes, I've had an EGD. It showed gastritis. I am going to the surgeon's office next week. Hopefully they will document enough this time to win an appeal. I'm so sick of this band. Can't get a fill because it causes issues & at the same time, I keep gaining my weight back because I need one.

Thanks for all the advice. I have an appointment next week with surgeons office. I will follow up as much as possible to document a malfunctioned band & file my appeal. I am hoping & praying I can have the revision before this year is over.

They denied my revision....Sad part about it, I work for them. I plan to appeal.

Thanks for the advice!

I called my advocate but she had left for the day. I did leave a detailed message. Hopefully I can see what's going on & start the denial process immediately. Thanks for the replies and advice!

Was for revision surgery or an initial WLS? Its been a week and I haven't heard anything. ...It's getting a lil nerve wrecking!

I have Humana. I'm hoping to get approved for revision surgery (from lapband to sleeve)

Good luck!

Mine was submitted on the 2nd but when I called the insurance company on the 9th, they said they haven't received anything. Called the doctor's and they resubmitted again. I called on the 10th to make sure they got it. (Which they did). The insurance rep said they sent a message back to the doctor's office stating they were missing my EGD and gall bladder US. So now I'm waiting on that to be sent. This process has been a test of my patience.

I'm waiting with you too! My paperwork was submitted to the insurance today. Good luck to you.

Hi Katherine I went back to my original surgeon's office. I am really hoping to just have one surgery but I know it will have to determine the condition of my band. Insurance only covers 50/50. I am hoping to have my surgery sometime in July.

Hi...Has anyone used Dr. Macik for revision surgery (lapband to sleeve).His office did inform me he does his surgery in two phases. If so, what was your experience with him. Thanks in advance!

Has anyone used Dr. Macik for revision surgery (lapband to sleeve), if so what was your experience. Thanks in advance!

I'm dealing with a slacker now...lol

Thanks for the ideas

To make a long story short. I had lapband in 2008, lost 90 lbs within a year and now have gained back 30 lbs. The band is no longer working for me. If I get a fill, I have problems, no fill= I eat more. I checked with my insurance, they cover WLS but only 50% after my deductible has been met, which it has. I've had my consult and he order my EDG, motility study and gallbladder ultrasound. Everything came back good for sleeve revision versus RNY. My insurance will not require me to go through the 6 month diet history and psych eval, etc because I am seeking revision. The problem is getting through to my advocate. I did not go to seminar again and for some reason, getting through to my coordinator/advocate has been an issue. I have let two messages but no return phone call. The good thing is I have an appointment scheduled with the nutritionist (scheduled prior to finding about no diet history needed). The nutritionist is in the same office as the advocate, so hopefully I can get some questions answered and tell her what the insurance company said. The only thing is I have a real good medical necessity letter. I will just pray they give me a good one and I am approved. I meet the requirements (BMI over 35 with 1 problem- joint issues plus I now have an auto-immune disease which was diagnosed last year. From what I've read, the lapband does not work well for that type of disease. It's just depressing to think about getting back up to 278 and my highest ever was 321. Currently, I weigh 221 which is depressing enough. I can not wear any of my clothes and it has been rough. I never thought I would be need my size 18 and 20s again but I do and I do not have them. I gave them all away making a vow to myself not to ever get that size again. But the lapband only worked for me for a few years. It would be nice to have surgery by June... We shall see. If I do not get a return call from my coordinator before my appointment with the nutritionist, I will get my questions answered then,

Hi, I am curious to know too. I currently have the lapband (since 2008) but seeking revision to sleeve. I was diagnosed with an autoimmune disease last year. Good luck on your journey!

Congrats!

Has anyone had surgery with Humana as their insurance? If so, is the approval process through them easy? Original insurance was Cigna with the lapband 5 years. Now, I'm trying to have revision surgery to the sleeve with my company's new insurer. Any helpful information would be greatly appreciated. Thanks

Thanks Nikimac and I know how you feel. My highest weight was 302 and then 278 when I had lapband. I managed to get to 189 but now I'm climbing back up. I'm toggling between 210-213

My insurance policy changed this year...went from 80/20 coverage to only 50/50 and only covering up to $10,000. The good part, they no longer have a cap on 1 lifetime procedure; which will be good if revision can not be done in one surgery. How much did your revision cost? With or without Insurance Thanks