Insurance Won't Approve Rebuckling Of Lap Band!

[Marianne390 0]

I had no problems getting approved for the surgery, but my band slipped and the surgeon had to go in and unbuckle it in October, and that too was approved by the insurance company. I am scheduled to have the band rebuckled on December 8th, but the insurance company denied the coverage for this surgery because my BMI is too low!! I lost 55 pounds originally and had another 30 or so to go, but since the band has been unbuckled I have gained back 15 pounds! Do I need to gain it ALL back so they will cover the surgery? OMG!! I am so frustrated right now and want my band back!! Any suggestions on how to convince the company that I need this surgery? How can they let me have an unbuckled lap band sitting in my body?

[cheryl2586 3,053]

What do you mean by unbuckle and rebuckled I did not think once the band was sewn in place it could be undone or it would have to be removed completely and replaced if thats what your talking about. Never heard of it being unbuckled because of a slip usually just unfilled or removed

[Marianne390 0]

Sanction, they put a realize band in, back in December 2010. I didn't know that the older or different models weren't able to be buckled and unbuckled. I guess there have been improvements with the band over time. I have decided to write a letter of appeal to the insurance company (United Healthcare) as instructed by them. I will let you know how I make out. They say they have 15 days to answer the appeal. Guess I will miss the December 8th scheduled surgery date...

[CindyBklyn 4]

15 days may be the average but if you have surgery scheduled the Dr can call the insurance company to escalate the request and hopefully speed it up. Good luck!

[Melinda Hohenberger 1]

I am sorry for my incorrect assumption as to who your insurance co is with. I had it in my head that you were covered by BCBS. I am so sorry that you have had trouble with it. I hope your outcome is positive.

Melinda

[Marianne390 0]

Thanks Cindy! I know the surgeon's office manager has been calling every day and they say someone will call her back and they never do. I have tried once myself, but I am going to call again tomorrow, as well as send my appeal in writing tomorrow. Hopefully I can wear them down!

Marianne