jodie1961

That is awesome! So glad you don't have to go thru any more of the insurance hoops. You are right, end of June is not that far away. Time keeps slipping by so fast. Another reason I want to get this weight off - I have 4 grandchildren and still have 2 kids at home, very active and I don't always feel like going, and going and going. Can't participate in many of their activities. I will so enjoy having more energy, and being able to do things with my family! I will keep all of us in my prayers for our surgeries, and recoveries. Keep in touch while we go thru this together!

They called all the tests came back good. See the surgeon May 2nd. You will be approved, if not now, fight it and it will go thru. I am gonna go with now for you...then, keep me posted on your progress. Maybe you will get your surgery close to mine, we can work it out together. Hang in there girl.

I have only told my husband and 4 grown children, one friend and one co-worker. Now that it is closer I told my mom (wasn't sure how she would take it) and my sister n law. So far all are very supportive. I was a bit worried about work, with the pre surgery diet, and the post surgery diet, all the dr visits I have gone to, but most know I had a lap band several years ago. It is obvious it was not working, so I have told them I am having it removed, which is true, if able they will do the rny Bypass at the same time, but coworkers will think the diet is for the band removal.

Good luck on your lift! You have done an amazing job!

My band worked great at first, but almost a year into it, I kept getting stuck. Then I had my gall bladder out, my lap band surgeon did the gall bladder. ( When I awoke, he told me he thought the band had slipped, so he completely took off my band and repositioned during the gall bladder removal. I had to go thru the whole shebang again, Clear liquids, full liquids, pureed, etc. My band never gave me any restriction after that. Had a 10cc band with 10 cc's and no restrictions. spent about 6-7 months trying to adjust to work. After 5years of getting food stuck on top of the band and having to go to the bathroom to throw up the stuck food, I went back and asked to get it removed. The rny bypass was something I decided on after making my mind up to get the band out. I am so glad to be on track now, looking forward to seeing the surgeon 5/2/14. Hoping to have surgery before June 1st or after July 15th. Coworker will be out with new baby in the middle. Good luck on your approval, and keep on them. Keep us posted on your progress, it is always nice to share and have someone in your corner!

Hi Sara G....I have BC/BS Anthem. I just got approved for lapband removal and revision to rny bypass. It took a bit longer because they approved the removal and denied the rny bypass first time. After communication opened up between the dr office and insurance, it was approved this past week. You should have no problems. If you do have a partial denial, make sure YOU call and ask the insurance company what you need to do next. The doc office misunderstood in my case and had me spend 2-3 months extra doing things not needed. When I finally spoke to the insurance company (and asked for a supervisor) I found out what they wanted. So stay proactive on your case if need be. And...good luck on your journey!

Feb 7th everyone signed off on my case so it could go to insurance. Drs. office didn't send to them until Feb 28th. Then took until end of March to find out insurance didn't need anything they sent (first request denied, by the way) except a peer to peer review by phone or an appeal the whole time. April 7th peer to peer review done by my doctor and the insurance doctor..approved! But, April 14th found out the paper work wasn't right...requested revised approval letter...took until today, April 23rd to get it done! So...signed, sealed and delivered APPROVAL!!! I go tomorrow for my chest xray-EKG and blood work. Patience has been worn out...but now I can see the light. I will pray for your answer to come much quicker. Chin up! It really does come through.

Good luck tomorrow with the rest of the tests. Hopefully they will show that your EKG was just off. Hang in there.

I got the call today! The insurance got the approvals on one form, and the dr office called me and sent orders for the pre-surgery lab work and tests. When they get that all back, they will schedule me to see the surgeon. Then the surgery date. It will either have to be really soon, or have to wait until my coworker comes back from having her baby. She is due in 6 weeks. I am okay with that.

Wow...May 6th! Maybe turning in with a date will get them on the ball to send the approval quickly. Even if it is a little later (June), that would be awesome. Keep us updated on your progress. I will try to get back on track. I can't let these things run my life. Thanks to this board and people like you it is easier to get through the rough patches!

Good luck on a fast answer...approval for surgery!! After 6 months of back and forth with insurance, I have my approval for band removal, and now approval for the RNY bypass.......but, they are on separate letters, one from Dec 2013 and the other April 2014! So, my Doctor's office won't schedule surgery until the insurance revises the letter to show both approvals on one form. It has been a week since they requested that. No word yet. Frustrated doesn't even describe my emotions. Praying all goes well for you, I would hate for anyone else to go through this.

I shared a bit ago...I was approved for band removal and denied for revision to bypass..after a long wait, and etc..found out I could request a peer to peer review (my doc to speak w/the insurance doc) after that they (ins) said I could appeal. I was approved after the peer to peer...didn't even have to go thru the appeal process. I was denied because they said "not medically necessary" Thank goodness I spoke with a supervisor at the insurance before doing the appeal. See if you can do this. Worth a shot! Best of luck.

I am sorry I didn't see this earlier. My lap band removal was approved w/my revision to RNY bypass being denied. Long story, but the insurance clerk at doc's drug out the process...all I needed according to my insurance was peer to peer review (my treating doctor to insurance doctor) to discuss reason for needing the revision surgery. Anthem bc/bs told me if I were to appeal first, I would give up my option for the peer to peer review. I called my doc office and they scheduled a review time (by phone). I got my approval letter that week! didn't even do an appeal letter. (now my dr office wants both approvals to be put on one letter, so I am waiting again for that). But...maybe a peer to peer review will help the insurance company to understand you are not doing this for weight loss but the effects of the GERD from the original surgery. Good Luck.

Okay...what a long process. First request in December for both band removal and bypass revision surgery.... Band Removal - approved Bypass revision - denied more stuff to do, etc, peer to peer review .....now this done April - Bypass RNY -APPROVED!! Don't get too excited yet....now my surgeon's office said they have to have both approvals on ONE letter. They cannot use the two separate approval letters??? What?? So, now I am waiting for the insurance company to send them a new letter w/both approvals. They have been trying to get thru to the insurance since Monday this week, no go yet. I am sooooooo getting worn out. Anyone else hear of this before?

Congrats! I got my approval Saturday, basically been waiting since December for process to go through. Regular doctor appointment was scheduled for the 21st, but the receptionist said they may re-schedule w/the surgeon instead so they can get surgery set. I am so relieved to finally be on this side of the insurance approval. Good luck on the rest of your tests, etc.

Where do you get powdered chocolate peanut butter (PB2)?

Thanks for the input...I am lucky to work where they will let me come back 1/2 days as well. Looking forward to seeing the surgeon and scheduling the surgery now.

Hang in there...you can do this! After all the hoops you have to go through, all the tests, all the classes, all the appointments....you CAN do this too. Drink Water til you can't put anything else in you. Keep us updated...let us know when you have surgery and how you are doing. And congrats on making this life changing decision.

Congrats on your losses and your gains! I can't wait to start my own ....got my approval letter from insurance today. Looking forward to playing w/my grandchildren again. Enjoy your new life!

It has been a long journey....approval for removal of my lap band was done December 13, 2013. They originally denied the revision to RNY. But after many months, dropped ball, etc..a peer to peer review was scheduled week before last. The day after my doc called and rescheduled my appointment because of unforeseen circumstances he was going to be off a week. I had put in my mind the review wouldn't happen until this week when he returned, but today I got the letter from my insurance company!!! Bless his heart, he must have spoken to them before he left. And I don't have to go thru the appeal process. Peer to Peer review process worked. Thanks to this site for all the support ..... really helped during the waiting time.

Good luck! Follow the Doc's orders and let us know how you do.

I trained last year with the YMCA for the 1/2 marathon. They had a couple of stores they suggested. Go to a sporting specialty store. They have someone watch you walk w/no shoes, to see how you walk, and if you roll your feet in or out when you walk, etc. They watch your knees and hips too. After that they chose a shoe that was made for that type gait. Mine in particular are Brooks. I walk on the insides of my feet. These have a very sturdy heel and force me to walk the correct way. They are pricey, about $120, but I am asking them to carry a lot of weight (mine) and go a lot of miles. All together with the training and the 1/2 marathon, I probably had about 200+ miles on them. I have new ones for this year. Spend the money, get professionally fitted, it will be worth it...because YOU are worth it! Keep up the good work.

Long story short...denied for revision from band to rny in December 2013. Insurance girl at Doc's office said we needed to re-do classes, psych eval, etc. Did this and got approval letter from NUT, Psych Dr, and Doc 2/7/13. Insurance girl didn't send in new clinical info to insurance until 2/26...after 10 business days I called Anthem and they said they had no new request on file. Called Doc office, insurance girl called me back and assured me they had everything. Still no word as of today...so I called Anthem again: a supervisor finally got on the phone and said there is no case pending. New clinical info doesn't do anything. the original request was denied -not medically necessary and now the only option is to have my Doctor call and have a peer to peer meeting to discuss, and/or file an appeal. (neither have been done.) Sooooooo in other words I have been waiting for NOTHING for nearly 2 months. I have to call my Doc's office Monday and talk to the insurance girl about scheduling a peer to peer meeting now. What is going on? Why would she not know this was needed? Why would Anthem continually tell me the case was pending when I called to check? I am soooooooooooo frustrated and depressed. Has anyone else ever been thru this?

Debbie (receptionist) called today and said she has the peer to peer meeting scheduled with my doctor and Anthem. I really don't understand exactly if this can reverse the original denial, or if it makes the appeal process have a better outcome? Has anyone else ever had a peer to peer meeting done on their case before being approved?

I think it is great that you have so many experiences to hear about on this site. I personally chose the Lap-Band originally because it was less invasive and had a much quicker recovery time. I just was one of the unlucky few that had problems. After one revision surgery on the band, and 2 years of trying to get the fill just right, I pretty much gave up. I have been seeing my doctor again since November, hoping to get a revision to RNY bypass. I lost approximately 80 lbs the first year, but after the problems, and second surgery, have gained nearly all back. So glad I still have options. That being said, many, many people have good luck w/the band and are still doing well years later. You really should listen to your doctor the most though, he/she knows your personal health history and will be the most unbiased about what you need to attain your goals. Good luck with your surgery, and here is to the new healthier you!