RayLandry

Dr, Snow in Trophy Club.

Lindstrom Healthcare Advocacy fought and won for me! An approval after two appeals! LHA rocks! Thanks Walter and Kelley!

Hello y'all! I just wanted let anyone, who is being denied by their insurance company, to consider Lindstrom Healthcare Advocacy, to help in your fight for approval or overturning a previous denial! My story.... I was denied coverage for revision surgery (lapband to sleeve) twice, by insurance xyz (I am not naming insurance company, until I get reimbursed), and enlisted Lindstrom Healthcare Advocacy for 3rd appeal and subsequently, a review by an independent doctor. After a few months of diligent and expert advocacy, on my behalf, LHA convinced the doctor and insurance xyz to finally approve my surgery! And this was almost 3 months AFTER my surgery, in which I funded myself! I am just waiting on reimbursement, which is in works now. I've talked to my insurance company and they are keeping me updated in the whole process. They have assured me that I am covered and reimbursement is in the making. Just a matter of claims and paperwork from my providers. Walter and Kelley Lindstrom, makeup the army that fights the good fight for you, by way of expert letters, phone calls, and legal knowledge. These guys are lawyers, who have made their primary scope, that of advocating healthcare, for those who need it. Insurance companies, in many cases, will use a multitude of reasons for denying coverage! In my case, insurance xyz was denying my coverage, due to a clause in our policy, that allows only one lifetime bariatric surgery. Walter Lindstroms letters and provided facts, convinced that my revision was not only necessary, but also eligible for coverage. Regardless of clause in policy. Kelley Brown Lindstrom, does ALL the leg work, as far as medical records and release forms. I can't say enough about her help and willingness to listen and answer all questions! She is simply genuinely awesome! As for the cost, it amounted to about 10% of the cost of my surgery. A risk indeed, but nonetheless, worth it. I will be getting back, minus deductibles and out of pocket maximums, about 90% of my total surgery cost! Three months AFTER my self paid surgery! My revision surgery was worth my self funding, regardless of an approval or not. I am now only 15 pounds from my goal weight, in just 16 weeks out of surgery! But with the help of Lindstrom Healthcare Advocacy, the victory is just that much more sweeter!

Like most things, you just never know until you try. I just self paid for my revision because my insurance denied removal and revision. They deemed it “medically unnecessary “. I am on my second appeal, with the help of an outside advocacy firm. I am praying this works to get me reimbursed! I too had the problems of reflux, pain, and night coughs. As a result, my esophagus was getting irritated. I am 18 days out from revision surgery and I feel great! Reflux is gone and I have already lost about 26 lbs! My BMI, at time of surgery was about 33. Not your typical 40+, like most bariatric surgery candidates. Good luck to you Kerri, hopefully you can get your insurance to pay for it! Believe me, I know firsthand, the negative outcomes of lapband!

Howdy, I am getting sleeved (revision, Band to Sleeve) in a couple of weeks. I have a question. I am an avid golfer and my buds from work and I, take a couple of golf trips a year. Usually to Myrtle Beach. Usually 4-5 days of golf and beer! We have a blast! Well, as much of a blast that 50 somethings can have. LOL . Our next outing is in late April and I am wondering how I will handle this! So, my question is this.......how is alcohol consumption after VGS? Is beer off limits? Thanks, Ray

I can see the probability of some kind of addiction! Thanks

Thanks guys!

Best of luck to ya!

Thanks....4 months. I may NOT need it! I KNOW, that I will pay better golf!

fingers are crossed!

Ha! Great point Jazzy! Never thought of that! Ray

Thanks for the advice guys. I dig y'alls passion and commitment! It's evident that y'all are winning the battle of obesity. I should have made my question a little more clearer. I totally understand that alcohol equals useless calories and can lead to poor choices in general, namely food consumption! I was referring to the sleeve itself, and the potential harm that alcohol could have on the healing sutures and such. As of now, I am self funding my revision (appeal in progress), so I am in no way planning to waste my hard earned money and sabotage my potential success. But having said that, I still want a life! I am a very light drinker and may go months without nary a drop. There are times and occasions that I like to be social and partake in the "party". That's all. Thanks, Ray

Well, I'm not sure if I am throwing good money after bad, but I just enlisted Lindstrom Obesity Advocacy to for a second appeal! Thanks Jenn for the recommendation. We'll see what happens! The cost of the assistance and advocacy vs. The surgery costs......well, it's a no brainer! I just hope that I didn't dig myself a deeper hole! Thanks ya'll

Jenn, thank you for the website! Since my surgery is only about 2 weeks away, do you think it is too late?

I am having my band revision to VGS in a couple of weeks. ON MY DIME! I guess my insurance felt that 2 WLS covered were the max! LOL Background here......Banded in 2005 ( insured), Band slipped and rebanded 2012 (insured), Revision set for 12/27 ( Out of pocket). Insurance denied because of prior surgeries. Oh well screw 'em! I'll pay for #3 my own dang self! Hopefully, with God's grace, this will be the answer!

I was banded back in 2005, then rebanded in 2012 (slippage). I've never really felt the restriction described by others. I did lose weight, but I think it was mainly from being more active and eating less. That's probably what the band is exactly meant for. A tool. Hopefully you will find your sweet spot!

Roy Orbison! Fellow Texan! Died way too young!

Good luck to all December Sleevers!

I too just had this gastric emptying test, back in July. No biggie at all. Eat a bit of egg, laced with isotopes and toast. They view progress every 30min (I believe). The hardest part was eating the egg!

Ooops! I mean revision #2! 2005 lapband 2012 band slipped, rebanded 2018 revision to vgs set for 12/27/18 I meant #3 surgery! 😄

Band to Sleeve Revision #3, Dec 27! So ready!

BCBS of Texas denied my appeal for lap to sleeve revision also! Even with letters and documentation from my doctors, their policy allows for only one bariatric surgery. Even with documentation about my chronic reflux! Heck with it, I am going self pay in December!

I too slipped and my surgeon replaced my band with plication. Consider the plication if that is an option. I am only 2 weeks out of surgery with an empty brand new band and I feel some big-time restriction! About a cup of food is making me feel full! I can only imagine what it is going to be like with a couple of fills! Plus, it is believed that plication can help prevent another slip. I truly hope so. best of luck to you!

It's all about the little victories! You are a winner and nobody is perfect. Just remember where you were and where you are now! That will keep things in perspective! Rock on!

This applies to men also! Good stuff! So true! Thank you!