DENIED

[lauriearnold 40]

just found out today that my insurance denied my 2nd appeal. Am thinking very seriously at this point to quit fighting with insurance and going to Dr Alvarez in Mexico. My lap band has to come out due to a prolapse that will not fix itself. Been unfilled since December 2013 and very very cautious of what i am eating right not to avoid any emergency surgeries. Has anybody on here gone to dr alvaraz and have a prolapsed band removed and sleeve done at same time. Help i'm desperate right now.

ldatda@hotmail.com

arkansas

[BeagleLover 1,020]

I suggest you look at Walter Lindstrom's blog on WLS appeals:

http://wlsappeals.com/2094/walters_bariatric_surgery_blog/20-years-bariatric-surgery-patient/

Don't give up!

[paula4422 2]

Can I ask why you were denied? I guess I dont understand if it "has" to come out how can they tell you no?

[BeagleLover 1,020]

What is your insurance? What is their appeal procedure?

[lauriearnold 40]

UHC paid for the band removal and i got the bill today guys and the hospital bill alone was $34, 648 and dr fee was $4900 and i don't owe anything. matter of fact im in the positive still. UHC will only pay for one bariatric surgery per life time. So, I'm having to wait 3 months for stomach to heal cause i had 2 holes in my stomach from the band that had eroded into my stomach. the only thing that was not in my stomach was the buckle part, the whole band was inside my stomach. So, now i wait 3 months and i pay for the sleeve myself which i'm fine with as long as i know i am getting it and i know i won't gain any weight. I can't get back into the gym until january and it's hard right now to go in and train my clients even cause i can't show them proper technique due to not being able to lift more then 10 lbs so i've had to put all my clients off till january too.

[BeagleLover 1,020]

Wow. Are you going to have the sleeve surgery done in the U.S.?

[lauriearnold 40]

Yes, in the US. I have a friend who's cousin went to Mexico and she came back with an extra incision and didn't know what it was so my friend talked her into going to the dr. They did a cat scan on her and she was missing a kidney!!!!!!! NO, no mexico. I'd rather keep my organs and pay more in the US and i will have follow up care here where if i go to Mexico i will not. I will have to go to an ER to have a gastro look at me. I've already got the money saved up so i'm just waiting for my 3 month healing time and getting it done.

[AmyElizabeth01 6]

My insurance wouldn't approve the lap band removal but did approve the sleeve. So I paid $600 for the band removal and insurance covered the rest. I'm so sorry you were denied. I still had to qualify, 40 bmi for last 5 years and all the other requirements.

[sukik 59]

Dr. Alvarez is the best! Even if my insurance would pay, I would go to Dr. A.