babygirlinokc

:biggrin0:Hi my name is babygirlinokc, I had a lap band done on 04-04-08. Did not work for me at all. So, 05-20-09 I had the lap band removed and the vsg done. Day and night!!! I love my sleeve. It totally ROCKS!!! The surgeon that did my sleeve was an out of network provider for Federal BCBS. Doctor told me that I should do self pay. Then Federal BCBS would reimburse me. They said the reimbursement would not be the full amount that I paid for the surgery (12,500.00) but some of it should come back. Well on the Obesity Help web site there were numerous amount of vsgers claimed Federal BCBS paid for their vsg the full amount. So, that is where I'm at right now. The claim that my doctor turned in had a cpt code of 43659, which Federal BCBS denied. :biggrin2: They do cover 43843. So, I asked my doctor if he could resubmit my claim with 43843. After researching the 43843 he said yes they would resubmit my claim with the cpt code 43843. Is anyone out there who had theirs covered at least most of it, by Federal BCBS? Thanks for responding!!! :wink:

Just wondering if some of you were approved with BCBS Federal? I was denied and I'm appealing. BCBS FED would not tell me the reason why it was denied they only said, the claim did not meet the criteria. That is all they could tell me over the phone. They said I would have to request this in writing. I am appealing this and asking in writting what was the reason it was not approved. I'm also requesting for a Bariatric Surgeon to be one of the consultants in the Appeal and Grievance Board. The band did not work for me at all. I was always starving. I hated it. I lost 17 lbs and then gained it all back and then some. Has anyone been approved for your revision from band to sleeve with BCBS Federal? Thanks. Thanks.

I agree you are not screwed. Appeal it. That is what I'm doing. :tongue_smilie: We have one of the best insurances in the country and to be federal employees th government is supposed to have really good benefits. It should not make a difference of region we live in. I already called OPM and they told me it did not matter what state you live in with BCBS Federal you only have to meet the criteria. I'm sending out my appeal today after work. I'm not giving up until I win.......If I don't win at least I tried........ babygirlinokc

Just wanted to share. I 'm so happy, I could CRY thats because I have lost a total of 33 lbs. I had a little stall a few weeks ago. My hair is coming out, but I think it's a good thing, it shows that this surgery worked and the weight is coming off. As compared to the lap band. This is so, so, so MUCH better!!! I have not really kicked in a lot of exercise either. I walk about 3 days a week about 30 minutes around the neighborhood. With the lap band I lost 17 lbs then gained it all back plus more. I will keep you all posted. Thanks for reading...... babygirlinokc 5'1" 48 years old VSG Surgery Date: May 20, 2009

Thanks VegasAngel so much for your help. I appreciate it. babygirlinokc:thumbup:

Please tell me what the difinitions of the following: New Post New Thread When you write a blog it only stay in your blog? How do you change the catogories when you type your blog? I have noticed when I typed one, it automatically became uncatogorized. How do you type something next to your pictures in your album? Thanks. :001_rolleyes:

So far, I have lost 33 lbs. Have not really been exercising, as I should be. The weight still is coming off. I was in a stall about 2 weeks ago. I have to remember this is a revision surgery and the weight might not come off as fast as the lst timers, virgin sleevers. I'm feeling really good about myself. Even though my hair is coming out. I think that's a good thing, it proves to me the surgery really worked and from what I hear that is one of the signs. I know that it will stop coming out and start growing back. I will keep you all posted. Thanks. :tongue_smilie:

Hi Everyone, I'm 48 years old, 5'1". Have had a weight problem since 1991. I had Diabetes II, High Blood Pressure, Sleep Apnea, High Cholesterol. Congested Heart Failure in my family history. I had lapband surgery on 04 April 08. I just hated. I did what I was suppose to. However, I was always starving. Yes, I had my fills and no the band did not slip. I lost only 17 lbs and then gained it all back. 20 May 09, I had the lapband removed and got sleeved. I'm so happy with this, it's working so much better for me. I still get hungry but not starving like I was before with the lapband. So far, I have lost 31 lbs. I'M SO LOVIN MY SLEEVE!!! :tongue_smilie:

Thanks cajun, I appreciate the info.

Had the lap band surgery in April 08. It did not work like I thought it would. I only lost about 17 lbs then gained it all back and then some. I hated to go and get the fills, food would get stuck sometimes and I would puke it up. I was always HUNGRY. :mad: My insurance paid for the band. When I inquired about the sleeve the doctor's office said that BCBS Federal would not cover the sleeve. :sad0: So, I did self pay. It was is so worth it. I love my sleeve so much. :svengo: I had my surgery on 20 May 09. I was 204 lbs on my lst consultation. Lost 10 lbs before surgery and have lost 20 more lbs. I still get hungry but not as much as I did with the lap band. I still have to be careful and not eat so much, cause I have puked up a few times cause I ate with my eyes, not with my tiny little stomach.....have to learn

Well, I just love this sleeve. :biggrin: I was 204 before surgery now I'm 174. I had my surgery on May 20, 2009. I have not really kicked in a lot of exercise, just walking 3 times a week for 30 minutes. I drink all my water and eat protein first. I'm 48 years old, I 'm not sure if that has anything to do with it. I do eat some no no's once in a while but just a tiny bit on the weekends. I don't really want to confess everything, before I did that and some other VSGers on Obesity Help. com came down really hard on me and made me go on a guilt trip. :scared0: It did get me thinking and I started to make better choices. Hope this helps. I guess I have to try to kick it up a notch on my eating and moving around (exercise). babygirlinokc

Hi Rebekah, How did your 1st consultation go? I bet you are excited. Hope it all went well for you. I will let you know when I find out about my claim. Have a great rest of the week..... babygirlinokc

Rebekah, I have a dumb question. What do you mean about having a Catastrophic cap?

Hi VegasAngel, Thanks so much for the welcome. I have a brother who lives in Boulder City!!! Wish I was there right now visiting with him..........

Susan, Thanks so much for the welcome!

Hi there, So glad that you responded. I too have Standard Option. I think it stated in the bcbs fep policy that 70% would be paid for the out of network providers. I am praying that I do get approved. My doctor already sent out the claim with the cpt code of 43843. Thanks for sharing. Blessings to you. babygirlinokc

Hi, I'm new on this forum. I was banded back in April 08. I first lost 13 lbs then I gained it back and then some. I did what I was supposed to do at first. However, I was still very hungry. I ended up eating more and I suppose I streched the pouch. Had 4 fills and 1 unfill. I know there is nothing wrong with the band, it just does not work for me. Had an upper GI and the doc said it is in place and looks normal. I'm going to get the sleeve done anyway. I need something a little better to help me. I know that I will have to stick to the portions and exercise on a daily basis. I just want to see if there is anyone out there that had this done. What is your progress? I'm 47 years old, 5'1", 204 lbs. Thanks. Please respond.

Thanks for replying. I have thoroughly researched and have decided to have the VSG done. I know that there is a difference between the sleeve and the band. The sleeve seems to be a better tool. I am not willing to get the RNY because of the rerouting my insides. I have to pay cash and the sleeve is about 8 thousand dollars cheaper. I have already started a change in my eating. I also decided to get off my lazy butt and exercise. Which I know these 2 things are a must with the VSG too. I have to lose 10 lbs before the doc does the VSG. So what I guess I trying to say is that I want a 2nd chance and I'm going to do what I'm supposed to do this time........... I will keep you posted on my progress.

Hi Nevergoback, How much weight have you lost now? I too am planning to get the sleeve done. I had my lap band surgery in April 08. So many people ask me on OH forum, ask me why I want to get a revision. I tell them it's because I failed the lap band. I guess I ate to much because I was alway hungry, I had 4 fills and 1 unfill, because, my food would get stuck. I believe one must have very strong will power. I lost 13 lbs with the band and gained back 16. It's been really depressing and fustrating. I had an upper GI and the band is normal. I'm going for the sleeve because it's less evasive and expensive than the RNY. Just checking to see how others out there have done with their revision from the lap band to the sleeve. Thanks so much.