Completed Pre-op Classes and Denied by Insurance Same Day

[RAAinNH 113]

Today started out great! I worked half a day and left early to finish my last pre-op class with the NUT and Nurse Practitioner. I even received a certificate showing that I completed their Bariatric Program. I was joking with fellow pre-sleevers in the group and stated that we all graduated the Ivy League, Dartmouth.

That's when things turned upside down. I received a call from the financing office informing me that my Sleeve surgery had been denied. My insurance is willing to cover the removal of my (good for nothing) Lapband but will not cover the Gastric Sleeve revision. What! Five months ago I got a pre approval. My insurance has been paying for all my pre-op classes, labs and Dr appointments. Now they are saying that because my Lapband does not appear to be eroded they won't pay for the Sleeve part of the operation.... but they will cover the removal. Doesn't make sense. My Surgeon will go to bat for me in an appeal. The Nurse Practitioner advised me to start my pre-op diet tomorrow and hopefully the decision will be reversed. She does not want to cancel my June 25th surgery date at this time.

I will not have the surgery unless it's for the full Monty. If I go ahead with just having the band removed, I feel that I will never be approved for the Sleeve.

Prayers and good thoughts sent my way is greatly needed and appreciated.

[serenity1959 67]

Prayers and good wishes sent your way!

[gummykandi 20]

Fingers crossed

[klelly1 20]

Oh My, im sorry to hear this, i am just starting the process of trying to get approved for the removal of my band and a revision to the gastric sleeve. I am hoping they reverse the decision for you, hoping this doesnt happen to me too. Can I ask why you want the band removed if there isnt anything wrong with it. I want mine removed because i struggled to lose weight with it. I would lose a little weight, quit losing weight, go in for a fill and no matter how small or how large the fill was my stomach would swell shut to the point that i couldnt even swallow my own saliva, so then i would have to get unfilled. ended up in the emergency room a couple of times. I had mine in mexico and the doctor that said he would do my aftercare when i got home changed his policies and wouldnt take any patients that he did not do the surgery for. so finally found a doctor 4 hours away and would travel there. He passed away in a car accident and then I had to look for a new doctor. Nobody wanted to take me, i went since 2005 without a doctor to deal with my band , finally the original doctor that changed his policy , changed it again and agreed to see me. Needless to say when I went in to see him he decided my band had been way too tight since 2005, ( i just thought it was suppose to be like that) i couldnt eat any good foods, just threw them up, only junk would slide down. i just figured i wasnt behaving and thats how the band is suppose to be. So after that long of living like that I just want the band out and want to convert to the sleeve. My new doctor told me that has been the experience with a lot of people with the lapband and some people just dont do well with the lap band. (which by the way he was a firm believer in the lap band years ago and now prefers the gastric sleeve) Also he sent me for all kinds of test and according to the tests my band is placed just fine, hasnt slipped and has not eroded. He also said there is a small percentage of people that he has seen that just do not tolerate the fills, and hes seen their stomachs swell shut also. I must be one of those. I was just wondering if you had any of these problems, meanwhile I will pray for your insurance company to reverse their decision and pray mine covers the removal and revision also. Good Luck to you