Insurance Won't Pay Soooo Have To Cancel Surgery

[Dee-Texas 5]

This is my update on band revision. I met with Dr. Clayton Frenzel in Arlington for the first consult. He was NOT the Doctor that put my band in. My original band doctor wouldn't return calls and I felt abandoned after he got my cash payment for the band.

I've been having problems for about a year now. I had band surgery in 2007. I lost a total of 75 lbs and stopped losing about 18 months after the band.

Dr. Frenzel did an endoscope to find out the problems. Seems my band was placed really lower than it was suppose to be...I was overfilled to the point my stomach has prolasped. They did find I had a hiaital hernia but even if they fixed it and did the sleeve....insurance would see the operative report and denine all payment. So not only would I have to pay for a sleeve or bypass but the hitial hernia as well ...out of pocket.

I have Blue Cross Blue Shield "risk pool" which means by law to have insurance they CAN and DO charge me 3 times the normal rate for insurance. They have denied all surgery to remove the band, port or any other type of surgery. So...I can't afford to self pay $14,000-$20,000 for a sleeve or bypass.

Im really just so very sad about the whole thing. So in essence I'm stuck with this thing in my body that doesn't work and is causing problems.

I wish all of you the best and happy losing.

[etexask 1]

have you considered going to Mexico?

[allnewme 262]

Many great surgeons in Mexico do revisions. Check them out, you may be able to self pay to get that band out if your body. I know Dr. Alvarez does them.

[mmc720 2]

Hi. I just joined the forum so this is my first post. But I just wanted to tell you not to give up hope. My insurance turned me down on my revision and finally on the last appeal they approved it. I wanted to give up so many times but my boyfriend wouldn't let me and told me I had to keep fighting it. I'm so glad I did. It did take over a year of fighting and going through 3 appeals but I finally had my revision on October 4th. And mine wasn't done by the same doctor who did my band surgery either. He's actually no longer even in the country.

I hope everything works out for you.

[Dee-Texas 5]

I just wanted everyone to know that Dr. Frenzel in Arlington would be my choice of surgeons if I could afford to self pay. Very highly thought of by his patients and Forest Park Medical Center.

My problem is my "crappy" insurance. Im in the BCBS risk pool and they will NOT pay for anything related to WLS. I talked to them and they just said...so sorry you're having the problem but there's is an exclusion and they won't pay..period.

IF I qualifed (who knows what that would be) I might could get in the Federal insurance if I didn't have insurance for 6 months. Pretty risky on a maybe.

Before I stopped coming to this site....I wanted to clarify about Dr. Frenzel..which I would recommend.

The Doctor that put IN my lap band I would NOT recommend.

[SugarTee 10]

Hello All!!!

I just wanted to respond... I am new also, although I have been lurking around the site several months ;-o...I just finished my last NUT visit on Wednesday and the coordinator submitted my paperwork the same day and I was approved for my Revision TODAY!!!!! Dr. Clayton Frenzel is my surgeon and I am going to have my surgery on November 8th. I have BCBS FEDERAL Insurance. My advice is to stay Prayed Up and DON'T Give Up.

[LovelyPea 16]

I actually had my band done in Mexico in 2008. I decided to have the revision from band to sleeve early this year. I completed the 6 month requirement that UHC had and just got approved for the revision on last week. Took 2 days!! Don't give up!!