Revision Approval?

[Butterfly66 63]

Hello Everyone! First, let me say I LOVE this site. Love all the support and encouragement from everyone. My daughter is getting ready to have revision surgery from band to RNY. Can anyone tell me what insurance approval was like for revision? Is a letter from the Dr. enough to justify approval? I have Altius Federal. Thanks! Christi

[SoccerMomma73 1,867]

My band slipped so removal was medically necessary and insurance approved it no problem. I was worried about revision approval because my BMI is now 36 and I have no comorbidities. However, for a change, insurance was fairly smart and said, since my band failed they would assume without the band I would return to my pre-op BMI (50) and my hypertension would return so the approved revision to whatever procedure my bariatric surgeon recommended....the entire approval from first phone call took 30ish minutes since it was considered an urgent surgery. Sadly, my stomach was inflamed and generally pissed off at the time so band was removed and I have a six month healing time before revision.

[Butterfly66 63]

Thank you so much!

[tashadelight 0]

I need a revision and was just denied by insurance does anyone have any suggestions for appeal