mom2sparky

My insurance company needs proof that there is a problem with the band or that it is giving me problems. So, my surgeon ordered an Upper GI barium swallow. Thankfully, I was able to talk with the radiologist about it before she started, and she seemed to understand. I went through the procedure and she stated that she did see acid reflux as well as a hiatal hernia. She could not determine if the band was in optimal position, so she said she would leave that for the surgeon to determine. All in all, I think this turned out well. I am meeting with the surgeon Monday and hopefully he will agree that there is enough of a problem to satisfy UHC. I had the band put in back in 2003, so it is long overdue to come out in my opinion. I was wondering if anyone else had a similar experience with needing to prove the band is causing problems. And if so, did you have trouble getting approval.

I am so frustrated. My United Healthcare policy will only pay for a revision if there is a malfunction with band, which means I have to get some kind of scope to see if this is the case. The surgery coordinator at my surgeon's office informed me of this yesterday, when she could have informed me last week. For whatever reason, the surgeon won't order this scope, I have to go to my primary doctor and request one, which wastes more time. However, I am going there next week, and I am sure one will be ordered right away. Problem is, there is probably not going to be any kind of "malfunction" with the band. I doubt it has slipped, and I would assume I would have noticed some symptoms if there was erosion. So if this scan turns out normal, I am screwed. Never mind that I have type 2 diabetes and severe sleep apnea, and the cost of my healthcare will be more expensive to UHC to shell out money for my medications, when this surgery could help end these problems. Has anyone else experienced this problem? Thank you in advance.

Congratulations! I am new to the board. I had my band placed in 2003, and it never worked for me. Not to mention the fact that I developed Type 2 diabetes and sleep apnea over the last few years.. I have gone back to my original surgeon and he is very on board with revising to GB. UHC will only cover it is there is something defective with the band. Good grief. I have to request a scope with my PCP, which I don't understand why my surgeon does not order one. So now I have to HOPE that I have something wrong with me in order to get mine approved. If I had $13,000 laying around, I would just have it removed and be done with it all. anyway, I am very happy for you.

I am so frustrated. My United Healthcare policy will only pay for a revision if there is a malfunction with band, which means I have to get some kind of scope to see if this is the case. The surgery coordinator at my surgeon's office informed me of this yesterday, when she could have informed me last week. For whatever reason, the surgeon won't order this scope, I have to go to my primary doctor and request one, which wastes more time. However, I am going there next week, and I am sure one will be ordered right away. Problem is, there is probably not going to be any kind of "malfunction" with the band. I doubt it has slipped, and I would assume I would have noticed some symptoms if there was erosion. So if this scan turns out normal, I am screwed. Never mind that I have type 2 diabetes and severe sleep apnea, and the cost of my healthcare will be more expensive to UHC to shell out money for my medications, when this surgery could help end these problems. Has anyone else experienced this problem? Thank you in advance.