casenior

Considering surgery in Mexico if UHC 100% denies me and I can't get it cheap enough here in Texas. Which Mexico surgeon/facility did you use? Any complications/infections? Sent from my iPhone using the BariatricPal App

Who here uses the Vitamin Patches? I'm considering switching to patches from gummies and wondering if they really work? Sent from my iPhone using the BariatricPal App

Will surgeons here in the states not take you as a follow up patient?? Sent from my iPhone using the BariatricPal App

Muscle build Sent from my iPhone using the BariatricPal App

@@ChickenChick I can guarantee they won't miss out on making money off you over something like that Sent from my iPhone using the BariatricPal App

it's your right to get your psych eval done by any provider of your choosing.. They cannot control that @@ChickenChick Sent from my iPhone using the BariatricPal App

It's been over 40 for 3 years including this year but insurance doesn't include the current year @@kmorri Sent from my iPhone using the BariatricPal App

Wondering who out there had success in getting their initial denial overturned? Would love to hear your story! Sent from my iPhone using the BariatricPal App

@@kmorri they already did the peer to peer and the guy was just a regular primary care physician and said he wasn't able to overturn the weight history denial but suggested we submit everything to appeals along with a letter explaining why.. This time I have other comorbidies as well so who knows. Hopefully an actual surgeon can review it. Sent from my iPhone using the BariatricPal App

@@kmorri I have 2 eligibility requirements. 5 years 40+ bmi and over the age of 21. They denied me for not having 5 years 40 bmi but this is a revision surgery for an eroded lapband I had removed in 2011.. I didn't get back up to 40 bmi until 2014 (lost 60 lbs with the band and it was covered under this same policy) Sent from my iPhone using the BariatricPal App

My insurance likely won't approve my surgery and my plan B fell thru. Looking for Houston TX surgeons that will bill insurance for a hiatal hernia repair then charge cash for remaining sleeve portion of the surgery. Sent from my iPhone using the BariatricPal App

Have you gotten an update? Sent from my iPhone using the BariatricPal App I was denied in the peer to peer as well so now it's on to appeals Sent from my iPhone using the BariatricPal App

I was denied first go round because I don't have 5 years of a 40 bmi because I had my lapband in place in 2011 but it eroded and was removed then. Took me about 2 years to fully regain the 40 lbs lost. My surgeon has the peer to peer next week. Hoping he'll overturn the denial. Sent from my iPhone using the BariatricPal App

So I have a fairly severe allergy to candida and also have autoimmune and need to take a daily probiotic to stay healthy. Is this something we can take post-op? If so, how do you take yours? Capsule, break the capsule, liquid form (if that exists)? Sent from my iPhone using the BariatricPal App

Thank you! Sent from my iPhone using the BariatricPal App

Richmond, tx here waiting on approval Sent from my iPhone using the BariatricPal App

I'm trying to get a revision procedure so I was initially denied due to not having 5 years 40 bmi. But my case is I had a procedure in place 5 years ago which explains why I only have 3 years. I'm praying my surgeon can overturn UHC's denial thru the peer to peer next week. It's giving me so much anxiety and depression right now Sent from my iPhone using the BariatricPal App

What is your exercise routine? The sleeve alone isn't a cure. If you're exercising maybe you've plateaued on your routine. Switch it up Sent from my iPhone using the BariatricPal App

So my company's policy only has 2 requirements for obesity surgery: 1. Minimum of 40bmi for 5 years & 2. Be a minimum of 21 years old I had lapband surgery in 2008 and lost 60 lbs before it eroded in 2011. I had to have it removed and by 2013 was back up to my pre-op weight of 255. At the time I was with another employer and weight loss surgery was an exclusion so no revision surgery for me. Last week UHC denied my request for the sleeve because I don't have 5 years of a 40 bmi.. Despite my doctors notes that I had another procedure in place in the beginning which was why I don't have 5 years. My surgeon's care coordinator told me yesterday that they have scheduled the peer-to-peer for next Tuesday. She said 9/10 times the "medical director" that reviews the requests is a primary care physician and they don't fully review everything submitted, they just look to see if you satisfy the eligibility requirements. So she is confident my surgeon can get them to overturn the decision. If this type of situation happened for you with United Healthcare (initial denial), what happened for you? Thank you! Sent from my iPhone using the BariatricPal App

, Sent from my iPhone using the BariatricPal App

I'm so sorry you're going through this I'll pray for you! Sent from my iPhone using the BariatricPal App

What is the average cost for the procedure in Mexico? Sent from my iPhone using the BariatricPal App

Have they figured out why you're having so many complications? This is wild to me. Sent from my iPhone using the BariatricPal App

It's a private group, but you're welcome to message me for info it initially began as a group for people that had their procedure in September 2015 but has grown to include more. Sent from my iPhone using the BariatricPal App

I don't have your experience, but am stopping to throw out a couple of thoughts. Maybe I'm missing something here. If the reviewer looks at the paperwork only to see if you meet the eligibility requirements (minimum 40 BMI for 5 yrs and 21+, as you report), it seems that you'll be rejected again. Wouldn't that mean it's likely that the initial denial will stand? It certainly won't hurt your peer-to-peer procedure if you supply letters in support of sleeve surgery from any and every doctor you can. These letters aren't about explaining why you don't have the required five years, but rather to state all the medical reasons you need to lose gobs of weight, all sorts of health and physical problems that are dangerous and can be solved by weight loss. If you do have doctors who can whip out brief letters, you need to move fast so that your insurance coordinator can get them to the peer review people. It can't hurt your case. If the process fails, you may choose to go to the next stage of appeal, whatever it is. I don't have personal knowledge of them, but there is a law firm that works on these things. If you'd want to consult, the head's is Walter Lindstrom. If worse runs to worst, would you be covered if you wait until you have 5 years of 40BMI? Would you be covered despite the earlier surgery? Just tossing out questions in case they haven't occurred to you. Good luck. Yes I'd be covered but I have other health issues right now that I need the procedure for.. And I work in oil and gas and chances are we will see more layoffs. My doctor should be able to justify that this is a revision of the failed procedure UHC covered me for before. That I have health issues now that would greatly be reversed through the weight loss. If I went in today to have my lapband removed, UHC would cover a revision. Hands down, no questions asked. My surgeon has had success in overturning their decision before and the care coordination rep I spoke with at UHC said that she sees the initial denials get overturned all the time especially for someone in my position. The peer to peer is a chance for my surgeon to sit down with the UHC medical director and clearly state the facts and fight for approval. If that fails the next step is appeals and that's where I would get any and all supporting documentation from my other physicians. Sent from my iPhone using the BariatricPal App