IMissVegas
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Everything posted by IMissVegas
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Denied again and surgeon's office is silent
IMissVegas posted a topic in Gastric Sleeve Surgery Forums
BCBS denied my lapband removal and revision to sleeve again. I received a letter saying that since my first bariatric surgery didn't get results, they wouldn't pay for a new one. This is despite the fact that I'm down 80 lbs and am in pain at the port site. To make things worse, the Nicholson Clinic seems to have forgotten me. I have to email and ask for a status or I never hear from them. Since I've met my OOP for the year, I met with an orthopedic surgeon and am having knee surgery on both knees next week. That way, I can exercise again. I feel that BCBS denied me because I've met my deductible and OOP and they don't want to pay for it. So now they can pay to fix my knees. Yes, I'm angry. What am I supposed to do about the port pain? Sent from my SM-N920P using the BariatricPal App -
Denied again and surgeon's office is silent
IMissVegas replied to IMissVegas's topic in Gastric Sleeve Surgery Forums
The surgeon's office called today and said if I go out of network next year to a specific hospital, then it will only cost me about $200. Apparently the hospital won't charge me a deductible or co-pay. This makes no sense to me. I have out-of-network benefits but why would the insurance pay for the surgery at all, even if it's for a hiatal hernia? I told the surgeon's staffer to call me back next week. I'm still on painkillers after my double knee surgery and this is making no sense to me. Sent from my SM-N920P using the BariatricPal App -
BCBS wants me to do 6 mos supervised diet before approving band-to-sleeve revision. We are appealing it, of course since I did a nutrition program through work and had 3 sessions with a nutritionist even before my obligatory session with a dietician. Also, there is medical necessity argument for removing band due to gastritis and port pain. Still, this is discouraging. I feel like because I worked hard to lose 80 lbs in the last 3 years and my BMI is now 35, they are going to deny me. Do they want me to regain the weight and become diabetic again? It would be easy to do. My band has had the Fluid removed and I'm so stressed that it would be easy to binge. Sent from my SM-N920P using the BariatricPal App
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Has anyone received a denial just for Band Removal?
IMissVegas replied to kristenmh's topic in Gastric Sleeve Surgery Forums
BCBS won't pay for my band removal even though I have a lot of port site pain. Of course the surgeon wants to do a revision, but they've denied it twice. I plan to appeal. Sent from my SM-N920P using the BariatricPal App -
BCBS denied first submission
IMissVegas replied to IMissVegas's topic in Gastric Sleeve Surgery Forums
Update: BCBS denied me again and it turns out my surgeon's insurance coordinator didn't turn in the letter I wrote or the dietician session information during the Pending More Info period. She says she is appealing, but I'm discouraged. I see an orthopedic surgeon tomorrow and am focusing on getting my knees and hip repaired so I can exercise. Sent from my SM-N920P using the BariatricPal App -
Bed Bath and Beyond if you can afford it and Walmart if you can't. The only negative with my Walmart pad is that I can feel the coils/cords through my sheets. My sister has the BBB ones and you don't feel them. But I paid $45 and she paid $200. I can live with feeling a cord now and then. Sent from my SM-N920P using the BariatricPal App
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I agree. My pets love it, too! Sent from my SM-N920P using the BariatricPal App
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Call your doctor and ask. Hang in there! Sent from my SM-N920P using the BariatricPal App
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Swimming and moisturizing, once you're allowed to swim, of course. Sent from my SM-N920P using the BariatricPal App
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Restart the liquid diet, lost weight again and also lost hairs?!
IMissVegas replied to Tara2000's topic in POST-Operation Weight Loss Surgery Q&A
Eat more Protein and make sure Biotin is included in your vits. Sent from my SM-N920P using the BariatricPal App -
Feeling whiny ..... would love advice.
IMissVegas replied to Pam924's topic in PRE-Operation Weight Loss Surgery Q&A
Congrats! Sent from my SM-N920P using the BariatricPal App -
Oh yes. The gas definitely causes shoulder, neck pain. It will get better. Sent from my SM-N920P using the BariatricPal App
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A Little Bit of a Difference
IMissVegas replied to Moogle's topic in Weight Loss Surgery Success Stories
Great job! Sent from my SM-N920P using the BariatricPal App -
Late decision change.
IMissVegas replied to Navigating the Wilderness's topic in PRE-Operation Weight Loss Surgery Q&A
Was it the office staff or the surgeon who made you feel bad? I'd make an appt w the surgeon to discuss why you changed your mind and why you need it done sooner. Sent from my SM-N920P using the BariatricPal App -
BCBS denied first submission
IMissVegas replied to IMissVegas's topic in Gastric Sleeve Surgery Forums
Thank you for the suggestion. I'll give it a try. Sent from my SM-N920P using the BariatricPal App -
It may still be a gas bubble from that gas they use to inflate the abdomin for surgery. That takes a long time to go away. Everyone says to keep walking and moving. Sent from my SM-N920P using the BariatricPal App
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Best Decision I Ever Made.
IMissVegas replied to nursey10465's topic in Gastric Bypass Surgery Forums
If it helps, I'm revising from band to sleeve and my surgeon says that with today's techniques, results from the sleeve are close to the bypass with very few of the side effects or possible future issues of the bypass. So I agreed to the sleeve. Sent from my SM-N920P using the BariatricPal App -
Wow! Just downloaded the app. Thx so much. Sent from my SM-N920P using the BariatricPal App
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5 days until surgery and 20lbs down.
IMissVegas replied to QueenOfTheTamazons's topic in Gastric Sleeve Surgery Forums
Great job! Sent from my SM-N920P using the BariatricPal App -
My lap band port pain is increasing daily as I jump through the insurance hoops to get approved for revision to sleeve. But I have my EGD tomorrow and nutritionist visit on Weds., then I'm done. Is anyone else going through this? Sent from my SM-N920P using the BariatricPal App
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I had my followup appt w surgeon yesterday. EGD showed chronic gastritis. They unfilled my band (yay), which hurt because of port area pain. The nurse was surprised that my port was located at the waistband area. The insurance paperwork gets submitted today or tomorrow. The surgeon doesn't expect them to deny band removal, and said if they deny the revision, he will still do it for a small fee ($500?) to cover use of stapling equipment. So I'm expecting to have surgery in 3-4 weeks. Sent from my SM-N920P using the BariatricPal App
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Complications with Banded Plication?
IMissVegas replied to jesse_ca712's topic in Gastric Plication Surgery Forum
I never heard of this before, so googled it. They fold the stomach into a smaller shape, similar to a sleeve, but don't cut the stomach. Is this being done in the US? The website says the procedure is in the "investigative" stage. The website said it was a lapband revision surgery. http://obesitycontrolcenter.com/surgery-options/gastric-plication/ Sent from my SM-N920P using the BariatricPal App -
Complications with Banded Plication?
IMissVegas replied to jesse_ca712's topic in Gastric Plication Surgery Forum
Plication? Sent from my SM-N920P using the BariatricPal App -
That's what Spanx are for! Sent from my SM-N920P using the BariatricPal App
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My EGD was a breeze and my nutritionist session was informative. I see my surgeon in a week for the followup appt., and then we submit to insurance. The really weird thing is that I swear my stomach/port pain is gone since I had the EGD. If anyone with a medical background has any idea of what happened, let me know! Sent from my SM-N920P using the BariatricPal App