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Lap Band Removal "Not Medically Necessary" says BCBS Federal!

abraxasbear

By abraxasbear, in Insurance & Financing

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abraxasbear    16

abraxasbear
Posted

Feeling very discouraged today. I called to follow up on the preauthorization for my band removal, and after placing me on hold, the rep came back to tell me they'd decided today to DENY, on the basis that it's "not medically necessary." This, after the surgeon has said it needs to come out as soon as possible.

Apparently a badly dilated pouch, with nausea and vomiting, isn't what they consider "necessary" to deal with. :( :( :(

Has anyone had success appealing for band removal, with no revision surgery? Especially with BCBS Federal Employee Program?

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BandtoSleevechick    171

BandtoSleevechick
Posted

I work for the state and have BCBS.. and a co worker had hers removed no issues.. appeal it .. goodluck!

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