Liv_94

Hello everyone, I’ve gone through the long process of trying to get a revision surgery after gaining most of the weight back after having the sleeve in 2014. I’ve had mental health issues in the years following and also developed GERD and High blood pressure in the recent years since. The insurance company (BCBS of North Carolina) has been giving me issues from the start first saying that my surgeon wasn’t in network so they wouldn’t cover the surgery. Upon further investigation from my doctors office the real issue was them denying my claim for a revision because there was a lack of evidence showing that I followed proper diet and exercise after my first surgery. Has any experienced something similar? I have the two comorbidities and my bmi is currently 45 so I’m just kinda in shock they denied me especially without even informing me.

Congratulations!!! Glad they decided in your favor. It’ll all be worth it!

I really hope they review quickly and reverse that decision for you!

Wow that’s more detailed than what they said to me. I don’t live in NC either my company is based in NC as well and this was the letter they sent me

For me I think I should’ve gotten a bypass in the first place but my pcp said I was so young and the sleeve was good so I just went along with it. At first I had no intention to get a revision even though I had gained almost all the weight back but I’m glad I did and I have no regrets.

I did not experience it with the sleeve either only when I had the bypass. It’s like being on the verge of throwing up, it’s kinda like when a baby spits up. Not pleasant at all and the only thing that really helps that for me is actually throwing up.

I would definitely say for the first few weeks don’t be discouraged! When I got home from the hospital I was 10 lbs heavier and it took some time to get that off and actually start losing. Also for myself I thought I could still eat at the speed I used to which was a big mistake that I’m still working on even now! I need to chew throughly or my stomach will definitely hurt. I’ve gotten better though because my first few months I would either throw things up or get the foamies. Lastly I can still tolerate things like sugar in small amounts but you’ll quickly learn that it really just depends on what it is. I’ve eaten a donut with no problem but then a few weeks ago I had a small bowl of Cinnamon Toast Crunch and was in the bathroom 3 times in an hour. I do mostly sugar free things but occasionally I’ll have something with regular sugar so it’s good that I know what I can and can’t tolerate.

Thank you! So far really well, on my surgery day in Dec 2022 I started at 265 and I’m currently down to 195

My doctor ended up doing a peer to peer with the insurance company and then it was approved and I had it as planned!

I did several appointments with the nutritionist before they submitted and that was another thing they tried to say I didn’t do so I’m not really sure what’s going on.

I know the insurance company is lying by saying the doctor is not in network because he already performed an endoscopy on me with no insurance issues. The doctors office accommodated me by giving me a surgery date because my employer was harassing me to give them information about when I’d be out and how long.

Well according to doctors office the insurance was trying to say he was out of network as an excuse. The hospital is in network and he’s employed by the hospital so he would be in network is what they told me. The doctors office has submitted information to my insurance company showing previous encounters notes with my past doctors so we’re waiting to hear back from that. They told me they will do a peer to peer if necessary. This just all stinks because my surgery is already scheduled and I am already on the liquid diet.