What do I say to get insurance to cover revision when band hasn't slipped?

[MaddieJ 82]

I am nervous because the insurance is questioning why I should have the revision when my band is intact and not eroded or slipped. If anyone has had good results getting insurance to cover in this situation please let me know what to say to them. The band totally failed for me. I am still hungry after I eat and weigh the same.

[JeffNNJ 111]

Your surgical coordinator should be able to help with that.

[Deena505 1]

My band slipped twice. You're lucky that it didn't slip! That hardest part ask your dr how to have insurance pay

[shannon crotts 23]

My doc said band intolerence and it worked!!!

[jlobyxmas 38]

My doc put dysphagia (trouble swallowing). Saw it on the chart.

[Eressa76 19]

My decision went peer to peer ( my doctor had to talk to the medical director of my insurance) used constant vomiting as my reason. Got approved sleeved 04/04/13

[angelbabys 6]

I am nervous because the insurance is questioning why I should have the revision when my band is intact and not eroded or slipped. If anyone has had good results getting insurance to cover in this situation please let me know what to say to them. The band totally failed for me. I am still hungry after I eat and weigh the same.

Band failed me also, mine was put in wrong and was never able to get it filled, but I constantly got things stuck having to make myself vomit, I told them my sob started mimicking me in vomiting, at times I had to pull over on the side of the road just to vomit, and my teeth were getting bad from all the vomiting, just some things I put in my letter

[soocalchic 1,087]

Continue to complain of acid reflux and abdominal pain that's why I had my revision

[Deena505 1]

ONE thing you should keep in back of your mind! DO NOT I mean DO NOT tell them you have acid reflux they will not approve u doing the sleeve! Sleeve makes the acid reflux worst and they will deny it! just tell them you are having lot of discomfort with band and you are having hard time keeping liquid and food down! DO NOT even bring up acid reflex!

[soocalchic 1,087]

ONE thing you should keep in back of your mind! DO NOT I mean DO NOT tell them you have acid reflux they will not approve u doing the sleeve! Sleeve makes the acid reflux worst and they will deny it! just tell them you are having lot of discomfort with band and you are having hard time keeping liquid and food down! DO NOT even bring up acid reflex!

Lies my chief complaint has always been acid reflux and port pain

[VSG Tommy B 10]

ONE thing you should keep in back of your mind! DO NOT I mean DO NOT tell them you have acid reflux they will not approve u doing the sleeve! Sleeve makes the acid reflux worst and they will deny it! just tell them you are having lot of discomfort with band and you are having hard time keeping liquid and food down! DO NOT even bring up acid reflex!

Acid reflux prevented my doctor from filling me any more than 3cc in a 10cc band. This left me constantly hungry. Yesterday I received insurance approval for the revision. I did get denied originally, but wrote a short letter appealing that decision. The whole process took 5 weeks. Can't wait to get my surgery.

[brandibandtosleeve2012 12]

I had my band for 4 years and while I didn't have complications, it sure didn't work. I went to a different surgeon and he wanted me to work with the band for a while because it wasn't anywhere near full. I asked that we please try to get insurance approval to revise and was initially denied. My surgeon and I decided to keep documenting my work with the band for at least a year. He said if we didn't give it at least a year then they would turn me down again. In that time I developed acid reflux and high blood pressure. The surgeon submitted the letter for approval and I got the approval two days later. It took a lot of time and patience but it finally paid off. I wish you the best in your journey from band to sleeve.

[MaddieJ 82]

Thanks for all the info! I called the doctors office and talked to someone that finally discussed my upper GI results and found out that the reason my band failed is because it's around my lower esophagus and not in the right spot. So my doc did a peer to peer and I just got approval!!!! I could not be more excited!!!!!!!!!!!!!!

[CiciDidi 1]

Mine was revised last year. Then it stopped working. I slowly gained and was getting more and more frustrated. I then got cellulitis and they said it would be better to take the band out. My body was rejecting it. Last month I had it taken out and now I am getting the sleeve June 12... With insurance they said it was covered because my body was rejecting the band.