SusanB55

OK, well after reading this thread, I'm not feeling real good about my own chances of: 1. being approved for band to sleeve revision and 2. waking up sleeved as I hope. My surgeon said that he usually does it in 2 surgeries as it is safer. I was pretty upset when I heard this. He said in my case, he would assess the situation when he goes in and if the 'rind' isn't too terrible, he will remove the band and continue with the sleeve. I still have some hurdles to jump. First, insurance authorization and then waking up sleeved.....waaaaaah. Now I'm depressed, lol.

This is what I am worried about. BCBS may not think my revision is medically necessary. So the doc is going to have to make the case that I've been vomiting for years and have already had one slipped band (not this current one tho as I had an upper GI-all looks ok) and a hiatal hernia. The other band was replaced under a previous insurance. It is REALLY going to suck when/if my husband has his sleeve and I'm still stuck with the band that is nothing but trouble.

I know! On one hand, I hate to draw attention to it and on the other hand, I don't want to waste time. But.......I did say on my initial visit to the main insurance/precert gal that I was surprised my surgeon didn't require me to get an endoscopy. She said nope, it's not checked so you don't have to. As for the cardiologist, she said since I am 9 years younger than my hubby (I am 56), I don't need cardiology clearance. I asked if she was sure, lol, and she kinda looked like she was insulted, but oh well. I then brought it up on one of my dr supervised appts who is also the assistant surgeon. He said "everyone" has a to have an endoscopy. I said "really? Everyone.? Well, I don't! " He just made some comments about why I wouldn't have to....it made no sense to me at all, but I guess my point is is that I brought it up on 2 different occasions to 2 different office personnel. Nobody said it must be a mistake so I guess maybe I'm just lucky in that regard. Time will tell! So I am holding my breath come this Thursday when I have my last NUT and dr supervised appts. I will see the insurance gal and tell her I'm ready and to go ahead and submit and see what she says lol.

The insurance should have said why it was denied!! Did anyone tell you why? After all I've read and heard, including numerous phone calls to my BCBS, there is protocol you need to complete prior to submission. You need Nutrition appts with a dietician, dr supervised weight loss appts, and psyche all within a certain amount of time. It varies with different insurance. You have the BMI covered, but sounds like that's all. You have to jump through all the hoops if you want to get approved. I would call insurance myself and ask how you can fix this.

Good luck tomorrow!! I'm going to try and track your posts and progress since my husband is being sleeved May 2 and hopefully me soon after him. I hope everything goes well for you!

What is your BMI?

I am so thankful our surgeon doesn't require a pre-op diet! He demands everything else tho, lol. We really like Body Fortress super advance whey Protein in chocolate. Don't get the isolate one! It's God awful terrible and the reviews support that assessment. We mix it with milk and PB2 and serve in a super cold glass.....yummy stuff. It is in an orange and black jug at good ol' walmart for around $18. That should take are of your chocolate cravings. Keep in mind, I'm not sure what you are not allowed to have during this pre-op diet, but I'm assuming protein shakes are permitted.

Looks like we may be on the same timeline! Have you done the endoscopy/cardiology or don't you need to either?

I called, they said it's still being put into the system and they have 30 days, unless your office submits it as urgent, ughhhSent from my XT1254 using the BariatricPal App Oh crap. That really, really sucks. I feel for you. I'm a very anxious person by nature and a total worry wart. And our cases, being revisions, are a bit more complex and expensive which i am sure bcbs isn't quick to approve. It may be a longer wait for me too and not so fast like my husband's.

Me too, my last dr supervised and NUT appts are on Thursday. Already did psyche. And that is all my surgeon checked as far as my testing goes. I already had an old sleep study done so supposedly i won't have to re-do that. Surgeon did not mark endoscopy or cardiology appt. Boy am I gonna be PISSED if he changes his mind. I should be ready to submit on Friday according to his initial surgery requirements sheet. My husband, on the other hand, had to do all the aforementioned appts/tests and I can only assume it is because he is 9 years older than i. His surgery was approved in 1 day by BCBS fed and is scheduled may 2 for surgery. Keeping fingers and toes crossed for both of us!

Call BCBS this morning! They may have a decision.

I'm in Tucson, AZ

Besides your BMI at 35, do you have any of the co-morbidities outlined by BCBS? I have a higher BMI than you plus sleep apnea. I know that 35 is the minimum BMI to qualify but you need another medical problem, according to them.

I was a nervous wreck for my husband's case. We knowingly submitted with only 2 NUT appts because the office had totally goofed up when they set up all his appointments. When I called bcbs, they told me that a dr supervised appt could count as a NUT appt as long as the documentation supported it. So I said, let's try it. I was so thrilled it was approved! He has almost every co-morbidity so that wasn't an issue. Thank you for explaining that to me. My doc is super cautious and was talking about leaks and depending on the 'rind' (?) Would determine whether or not he would do both. I guess we will be submitting on me after my appt on Thursday,. I will then be in the same situation as you. Gulp! I have to pay two surgeon copays, do you? Ugh. $200 each. And times 2 people, lol. My husband reminded me that the letter we received for him was actually dated April 8th, one day after it was submitted! I was too scared to call to check know the status but maybe you should call tomorrow instead of waiting for the letter. Please let me know what insurance says! I'm rooting for you.

Are you waiting for your surgery approval? My husband and I have BCBS Fed and it was submitted to insurance on April 7 and we received the approval letter on April 13. We were surprised it came so fast. I have heard some BCBS patients hearing within 48 hours and others 3 weeks. We were super nervous too! Like you, I have a band and am going to my last NUT appt this Thursday. I hope I am approved as well for the sleeve. My husband and I were hoping to be going through this together. For 10 years we have been on different eating schedules due to my band and all the difficulties it presents. There is more to prove to the insurance for a revision. Did your surgeon tell you that the band and port would be removed in one surgery and then the sleeve would come later on? My surgeon told me this but when he saw how upset I became he said he would see how it looks when he goes in and if it looks safe to do the sleeve, he will. So I won't even know until I wake up if I am sleeved or not.

Hubby and I haven't had our surgeries yet but our NUT told us about PB2. It's wonderful! I first found it at Big Lot's but then I ran across it at COSTCO! Great deal!

I'm so glad my surgeon doesn't require a pre-op diet.

Ugh, I don't like hearing that you are hungry! I thought the surgery removes the 'hunger enzymes'? My husband is going to be sleeved May 2 and hopefully I will be approved a bit later. I have heard some people are not at all hungry post sleeve and others are. If you have boullion you can make some broth with that. Good luck to you. I hope it gets easier for you!

Congrats!!! Woo hoo!!! You go girl I hope my husband and I lose all of our cravings too!

Congrats My husband was just approved quickly by BCBS Fed. It's a good feeling, isn't it? Next up is me. Gulp! Not sure what you mean about a pre op test?

These responses give me some hope too, lol. I have a friend in Texas whom I met in Mexico getting banded 10 years ago. She had the revision to sleeve and loves it. She says that bread is really hard for her to eat, which is just like a band. She says the bread swells up and it is too uncomfortable to eat. I have been really asking her a lot of questions since my husband is getting sleeved on May 2 and hopefully I will follow if I am approved. Initially she had lost a lot of weight post sleeve but regained 40 pounds because of the sweet tea she loves so much. She says she just can't give it up.

My husband is being sleeved May 2. I have had a band for 10 years and am going through the process as well hoping to get approval for a revision. My surgeon unfilled me 2 months ago and I've been eating anything and everything ever since. I haven't been able to eat without throwing up for all these years and some foods I just couldn't even attempt. So I am like a kid in a candy store. I know I am going to regret it. If I am denied, I guess I'll have to have the band refilled and start puking again.

Sarah, my husband and I are both trying to get the sleeve. We have BCBS Fed and live in AZ. Our surgeon's office hasn't made any demands that we need to lose any weight prior to surgery nor do they believe in the pre-op liquid diet just prior to surgery. After reading so many people say they had to lose 5% before surgery, I am kinda worried now. I am currently banded but had an unfill 3 months ago and have gained about 15 pounds (last I checked). My husband has never had bariatric surgery. Thank you

Then mines must know something that so many others don't know...lol I'm running in the opposite direction. Sleeve all the way. Sent from my SM-G935T using the BariatricPal App I have been banded for 10 long years. Hoping to get a revision to the sleeve. Crissy, do NOT get the band!!! I. HATE. IT! I have gone through so much crap with the band and it has been horrible. Don't do it!!! My surgeon doesn't even do them anymore, so what does that tell you? I will be devastated if my ins doesn't approve me for the sleeve.

My husband and I are both going through all the hoops required for bariatric surgery. During all this time, nobody has said we actually needed to lose any weight and they also do not present op diets. I have gained weight as a result of getting my band unfilled a few months . Ugh!