DrHekier

In our clinical practice we have seen that a lot of patients have a hiatal hernia and they don't even know about it. They might have had vague symptoms, such as occasional GERD or mild nausea from time to time, but were never diagnosed with a hiatal hernia. Most LapBand surgeons will closely look for a hiatal hernia in the first part of the surgery, and if you have one fix it at that time. Don't worry, it won't interfere with your surgery.

First of all, remember that one person's Cigna may be different than another. Having said that, in our practice, we have found that nearly all insurance companies go by the BMI at the time of the first evaluation by the bariatric surgeon, so you should be fine. Do the best you can on the 6 month program to lose all the weight you can. The healthier you are going into the surgery, the more likely you will have a speedy recovery and a safe outcome. Good luck!

Great! Thanks for the update! I don't understand the confusion and why our office is getting so many phone calls. We will give them the number you posted. The Internet is great! Thanks sarahbethlane :thumbup:

In the past few weeks our office in Texarkana has received multiple phone calls by patients in Arkansas who had a LAP-BAND® placed by Dr. Rex Luttrell. It appears that these patients are unable to get a hold of Dr. Luttrell and they indicate he may have moved his practice to an unknown location since the office staff can't answer to his whereabouts. I'm trying to save our staff multiple phone calls by posting this. In order to accept a new patient we would need to get a copy of your operative report and clinic visit notes to evaluate prior to accepting you as a patient. Thanks,

In your doctor's defense, in my experience Aetna is one of the worst payors for Lap Bands and we physicians never know what they will do. I once had to wait 9 months until I got paid by Aetna for a LAP-BAND®, and of course this was pre-authorized by them in the first place. My biller was calling them every few days for several months and getting nowhere. Only after I intervened and started calling every few days for a couple of weeks, did they relent and agree to pay. A lot of patients aren't aware of the hassles that the doctors office goes through to get paid. I don't know the specifics of your situation, and I admit I am biased, but I have to take the side of the doctor's office over the insurance company. Especially Aetna. Even when they say they pay, they might take many many many months. Most importantly, congrats on your impending LAP-BAND®!:smile2:

Thanks for taking action. The more I read about Blue Cross Blue Shield the more disgusted I am. The LA Times had an expose a few years ago detailing how BCBS employees are praised for dropping coverage for sick patients, people with diseases such as cancer, or pregnancy. Search for the term "rescission." It is their term for getting rid of policy holders that will require medical treatment soon.

Unfortunately if she has an exclusion it is almost impossible to overturn that. In desperate cases, I suggest seeking the services of an attorney advocate for weight loss surgery patients, Walter Lindstrom. Obesity Law and Advocacy Center Walter himself has undergone WLS.

Work with your doctor's office. Each policy is different. One person's BCBS of TX policy may have different requirements than another person's Regarding what might work: we once had a patient that lacked one year of her five year weight history as do you. We provided a picture of her that was taken during her "missing year" which showed that she was at a similar weight as noted on her doctors notes for the years before and after. Good luck!!

I wouldn't worry about it. It looks like someone submitted for approval for an infusion pump, which is not commonly used in Lap Band surgery and a nerve injection which is never used. This seems to have nothing to do with your surgery. Congrats!

Regrettably there is a surgeon from Little Rock that is still practicing Lap Band surgery that reportedly has lost privileges at multiple hospitals in Little Rock. I understand he has resorted to taking his patients out of Little Rock to a small hospital in a small town that has given him privileges.